41D0084679 CLIA NUMBER - CHARLES J DE ANGELIS MD

Laboratory Demographics

  • CLIA Code: 41D0084679
  • Facility Name: CHARLES J DE ANGELIS MD
  • Facility Address: 1199 RESERVOIR AVE
    CRANSTON, RI
    ZIP 02920
  • Facility Phone: 401 942-4700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHARLES J. DEANGELIS MD
  • NPI Number: 1801904180
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 41D0084679
LAB Type Physician Office
Facility Name CHARLES J DE ANGELIS MD
Street 1199 RESERVOIR AVE
City CRANSTON
State RI
ZIP 02920
Phone 401 942-4700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2024
Certificate Expiration Date 6/27/2026
Facility Type Physician Office
Lab Director CHARLES J. DEANGELIS MD

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