22D2295335 CLIA NUMBER - BAYSTATE MRI & IMAGING CENTER, LLC

Laboratory Demographics

CLIA Number: 22D2295335

Facility Name: BAYSTATE MRI & IMAGING CENTER, LLC

Facility Address:
80 WASON AVE
SPRINGFIELD, MA
ZIP 01107
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Facility Phone Number: 413 730-9200

Facility Type: Other - CLINIC

Certificate Type: Waiver

NPI Number: 1558310474

Taxonomy: 261QM1200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	22D2295335
LAB Type	Other - CLINIC
Facility Name	BAYSTATE MRI & IMAGING CENTER, LLC
Street	80 WASON AVE
City	SPRINGFIELD
State	MA
ZIP	01107
Phone	413 730-9200
CertificateType	4
CertificateEffectiveDate	12/8/2023
CertificateExpirationDate	12/7/2025
FacilityType	Waiver

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