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22D2257681 CLIA NUMBER - VMD PRIMARY PROVIDERS MASSACHUSETTS, PLLC

Laboratory Demographics

CLIA Number: 22D2257681

Facility Name: VMD PRIMARY PROVIDERS MASSACHUSETTS, PLLC

Facility Address:
215 BEACH STREET
MALDEN, MA
ZIP 02148
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Facility Phone Number: 713 461-2915

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1235879370

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 22D2257681
LAB Type Physician Office
Facility Name VMD PRIMARY PROVIDERS MASSACHUSETTS, PLLC
Street 215 BEACH STREET
City MALDEN
State MA
ZIP 02148
Phone 713 461-2915
CertificateType 4
CertificateEffectiveDate 4/8/2024
CertificateExpirationDate 4/7/2026
FacilityType Waiver

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