22D2309823 CLIA NUMBER - DEPARTMENT OF PSYCHIATRY AT BIDMC

Laboratory Demographics

  • CLIA Code: 22D2309823
  • Facility Name: DEPARTMENT OF PSYCHIATRY AT BIDMC
  • Facility Address: 75 FENWOOD RD- 5TH FLOOR
    BOSTON, MA
    ZIP 02115
  • Facility Phone: 248 885-1057
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATCHERI S. KESHAVAN
  • NPI Number: 1194840975
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 22D2309823
LAB Type Physician Office
Facility Name DEPARTMENT OF PSYCHIATRY AT BIDMC
Street 75 FENWOOD RD- 5TH FLOOR
City BOSTON
State MA
ZIP 02115
Phone 248 885-1057
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2024
Certificate Expiration Date 8/20/2026
Facility Type Physician Office
Lab Director MATCHERI S. KESHAVAN

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