22D2237712 CLIA NUMBER - KEYSTONE PLACE AT BUZZARDS BAY, LLC

Laboratory Demographics

  • CLIA Code: 22D2237712
  • Facility Name: KEYSTONE PLACE AT BUZZARDS BAY, LLC
  • Facility Address: 218 MAIN STREET
    BUZZARDS BAY, MA
    ZIP 02532
  • Facility Phone: 774 302-4539
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DEANNA ROUX
  • NPI Number: 1790399970
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 22D2237712
LAB Type Assisted Living Facility
Facility Name KEYSTONE PLACE AT BUZZARDS BAY, LLC
Street 218 MAIN STREET
City BUZZARDS BAY
State MA
ZIP 02532
Phone 774 302-4539
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2025
Certificate Expiration Date 9/27/2027
Facility Type Assisted Living Facility
Lab Director DEANNA ROUX

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