22D2193504 CLIA NUMBER - MEDFORD SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 22D2193504
  • Facility Name: MEDFORD SURGERY CENTER
  • Facility Address: 170 GOVERNOR AVE
    MEDFORD, MA
    ZIP 02155
  • Facility Phone: 215 407-2745
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SOHAIL HUSAIN
  • NPI Number: 1073149365
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 22D2193504
LAB Type Ambulatory Surgery Center
Facility Name MEDFORD SURGERY CENTER
Street 170 GOVERNOR AVE
City MEDFORD
State MA
ZIP 02155
Phone 215 407-2745
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2024
Certificate Expiration Date 9/21/2026
Facility Type Ambulatory Surgery Center
Lab Director SOHAIL HUSAIN

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This page was last updated on: 9/29/2025