22D2314181 CLIA NUMBER - BODYWISE HEALTH COLLABORATIVE, PLLC

Laboratory Demographics

  • CLIA Code: 22D2314181
  • Facility Name: BODYWISE HEALTH COLLABORATIVE, PLLC
  • Facility Address: 75 SOUTH CHURCH ST
    PITTSFIELD, MA
    ZIP 01201
  • Facility Phone: 413 298-2420
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MOLLY Z. RIVEST
  • NPI Number: 1104658343
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 22D2314181
LAB Type Practitioner Other
Facility Name BODYWISE HEALTH COLLABORATIVE, PLLC
Street 75 SOUTH CHURCH ST
City PITTSFIELD
State MA
ZIP 01201
Phone 413 298-2420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2024
Certificate Expiration Date 11/13/2026
Facility Type Practitioner Other
Lab Director MOLLY Z. RIVEST

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