22D2199900 CLIA NUMBER - STEPHEN M VULTAGGIO DDS, PC

Laboratory Demographics

  • CLIA Code: 22D2199900
  • Facility Name: STEPHEN M VULTAGGIO DDS, PC
  • Facility Address: 115 THOREAU ST
    CONCORD, MA
    ZIP 01742
  • Facility Phone: 978 371-2792
  • Facility Type: Other - DENTAL
  • Facility Type: Waiver
  • Lab Director: STEPHEN M. VULTAGGIO
  • NPI Number: 1891852356
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 22D2199900
LAB Type Other - DENTAL
Facility Name STEPHEN M VULTAGGIO DDS, PC
Street 115 THOREAU ST
City CONCORD
State MA
ZIP 01742
Phone 978 371-2792
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2024
Certificate Expiration Date 11/11/2026
Facility Type Other - DENTAL
Lab Director STEPHEN M. VULTAGGIO

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