22D2294642 CLIA NUMBER - PROVINCETOWN IB SCHOOLS (PUBLIC SCHOOL)

Laboratory Demographics

  • CLIA Code: 22D2294642
  • Facility Name: PROVINCETOWN IB SCHOOLS (PUBLIC SCHOOL)
  • Facility Address: 12 WINSLOW ST
    PROVINCETOWN, MA
    ZIP 02657
  • Facility Phone: 508 487-5216
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: ANGELA M. STAGAKIS
  • NPI Number: 1184029183
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 22D2294642
LAB Type School/Student Health Service
Facility Name PROVINCETOWN IB SCHOOLS (PUBLIC SCHOOL)
Street 12 WINSLOW ST
City PROVINCETOWN
State MA
ZIP 02657
Phone 508 487-5216
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/28/2023
Certificate Expiration Date 11/27/2025
Facility Type School/Student Health Service
Lab Director ANGELA M. STAGAKIS

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