41D0857124 CLIA NUMBER - BLACKSTONE VALLEY CNTR FOR INTERAL MED

Laboratory Demographics

CLIA Number: 41D0857124

Facility Name: BLACKSTONE VALLEY CNTR FOR INTERAL MED

Facility Address:
191 SOCIAL ST #840
WOONSOCKET, RI
ZIP 02895
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Facility Phone Number: 401 658-3467

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1417224767

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

CLIA Record

Field Name	Field Value
CLIA Number	41D0857124
LAB Type	Physician Office
Facility Name	BLACKSTONE VALLEY CNTR FOR INTERAL MED
Street	191 SOCIAL ST #840
City	WOONSOCKET
State	RI
ZIP	02895
Phone	401 658-3467
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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