22D2310159 CLIA NUMBER - CVS CLINIC, PLLC

Laboratory Demographics

  • CLIA Code: 22D2310159
  • Facility Name: CVS CLINIC, PLLC
  • Facility Address: 19 DODGE ST, SUITE B
    BEVERLY, MA
    ZIP 01915
  • Facility Phone: 718 678-7424
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID G. FAIRCHILD
  • NPI Number: 1629832225
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 22D2310159
LAB Type Physician Office
Facility Name CVS CLINIC, PLLC
Street 19 DODGE ST, SUITE B
City BEVERLY
State MA
ZIP 01915
Phone 718 678-7424
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2024
Certificate Expiration Date 8/27/2026
Facility Type Physician Office
Lab Director DAVID G. FAIRCHILD

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