41D0083228 CLIA NUMBER - MIDLAND MEDICAL ASSOC

Laboratory Demographics

CLIA Number: 41D0083228

Facility Name: MIDLAND MEDICAL ASSOC

Facility Address:
315 COMMONWEALTH AVE STE A
WARWICK, RI
ZIP 02886
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Facility Phone Number: 401 463-3380

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1407871270

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	41D0083228
LAB Type	Physician Office
Facility Name	MIDLAND MEDICAL ASSOC
Street	315 COMMONWEALTH AVE STE A
City	WARWICK
State	RI
ZIP	02886
Phone	401 463-3380
CertificateType	4
CertificateEffectiveDate	1/29/2024
CertificateExpirationDate	1/28/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024