41D0665968 CLIA NUMBER - COASTAL MEDICAL METACOM PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 41D0665968
  • Facility Name: COASTAL MEDICAL METACOM PRIMARY CARE
  • Facility Address: 639 METACOM AVE
    WARREN, RI
    ZIP 02885
  • Facility Phone: 401 245-1500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSEPH J. ZIBRIDA
  • NPI Number: 1629449210
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 41D0665968
LAB Type Physician Office
Facility Name COASTAL MEDICAL METACOM PRIMARY CARE
Street 639 METACOM AVE
City WARREN
State RI
ZIP 02885
Phone 401 245-1500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2024
Certificate Expiration Date 12/31/2025
Facility Type Physician Office
Lab Director JOSEPH J. ZIBRIDA

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