22D2266169 CLIA NUMBER - NUEVO DIA ADULT DAY HEALTH CENTER

Laboratory Demographics

CLIA Number: 22D2266169

Facility Name: NUEVO DIA ADULT DAY HEALTH CENTER

Facility Address:
75 AMORY ST
ROXBURY, MA
ZIP 02119
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Facility Phone Number: 617 959-6593

Facility Type: Other - ADULT DAY HEALTH CENTER

Certificate Type: Waiver

NPI Number: 1104583848

Taxonomy: 261QA0600X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	22D2266169
LAB Type	Other - ADULT DAY HEALTH CENTER
Facility Name	NUEVO DIA ADULT DAY HEALTH CENTER
Street	75 AMORY ST
City	ROXBURY
State	MA
ZIP	02119
Phone	617 959-6593
CertificateType	4
CertificateEffectiveDate	8/6/2022
CertificateExpirationDate	8/5/2024
FacilityType	Waiver

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