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22D2241402 CLIA NUMBER - PM PEDIATRICS OF NEW ENGLAND, BRAINTREE

Laboratory Demographics

CLIA Number: 22D2241402

Facility Name: PM PEDIATRICS OF NEW ENGLAND, BRAINTREE

Facility Address:
97 PEARL STREET
BRAINTREE, MA
ZIP 02184
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Facility Phone Number: 781 848-5437

Facility Type: Other - URGENT CARE

Certificate Type: Waiver
NPI Number: 1073270484

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 22D2241402
LAB Type Other - URGENT CARE
Facility Name PM PEDIATRICS OF NEW ENGLAND, BRAINTREE
Street 97 PEARL STREET
City BRAINTREE
State MA
ZIP 02184
Phone 781 848-5437
CertificateType 4
CertificateEffectiveDate 10/28/2023
CertificateExpirationDate 10/27/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024