41D0082689 CLIA NUMBER - BLACKSTONE VALLEY COMMUNITY HEALTH CARE, INC

Laboratory Demographics

  • CLIA Code: 41D0082689
  • Facility Name: BLACKSTONE VALLEY COMMUNITY HEALTH CARE, INC
  • Facility Address: 39 EAST AVE
    PAWTUCKET, RI
    ZIP 02860
  • Facility Phone: 401 729-0081
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: CRISTINA PACHECO MD
  • NPI Number: 1942473103
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 41D0082689
LAB Type Federally Qualified Health Center
Facility Name BLACKSTONE VALLEY COMMUNITY HEALTH CARE, INC
Street 39 EAST AVE
City PAWTUCKET
State RI
ZIP 02860
Phone 401 729-0081
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Federally Qualified Health Center
Lab Director CRISTINA PACHECO MD

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