22D2307877 CLIA NUMBER - EVERNORTH CARE PROVIDERS - DELAWARE PA

Laboratory Demographics

  • CLIA Code: 22D2307877
  • Facility Name: EVERNORTH CARE PROVIDERS - DELAWARE PA
  • Facility Address: 300 BAKER AVE., SUITE 300
    CONCORD, MA
    ZIP 01742
  • Facility Phone: 877 663-1333
  • Facility Type: Other - IN HOME PCP
  • Facility Type: Waiver
  • Lab Director: SHANNON ALSOP
  • NPI Number: 1013776970
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 22D2307877
LAB Type Other - IN HOME PCP
Facility Name EVERNORTH CARE PROVIDERS - DELAWARE PA
Street 300 BAKER AVE., SUITE 300
City CONCORD
State MA
ZIP 01742
Phone 877 663-1333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2024
Certificate Expiration Date 7/16/2026
Facility Type Other - IN HOME PCP
Lab Director SHANNON ALSOP

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