22D2199617 CLIA NUMBER - BASTIEN DENTAL

Laboratory Demographics

  • CLIA Code: 22D2199617
  • Facility Name: BASTIEN DENTAL
  • Facility Address: 3 PROPRIETORS DRIVE UNIT 12
    MARSHFIELD, MA
    ZIP 02050
  • Facility Phone: 410 837-3700
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DAVID M. BASTIEN
  • NPI Number: 1154441855
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 22D2199617
LAB Type Practitioner Other
Facility Name BASTIEN DENTAL
Street 3 PROPRIETORS DRIVE UNIT 12
City MARSHFIELD
State MA
ZIP 02050
Phone 410 837-3700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/10/2024
Certificate Expiration Date 11/9/2026
Facility Type Practitioner Other
Lab Director DAVID M. BASTIEN

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