41D0866256 CLIA NUMBER - INTERNAL MEDICINE ASSOC INC

Laboratory Demographics

  • CLIA Code: 41D0866256
  • Facility Name: INTERNAL MEDICINE ASSOC INC
  • Facility Address: 1150 RESERVOIR AVE SUITE 201
    CRANSTON, RI
    ZIP 02920
  • Facility Phone: 401 943-1300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL W. RODERICK
  • NPI Number: 1376553990
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 41D0866256
LAB Type Physician Office
Facility Name INTERNAL MEDICINE ASSOC INC
Street 1150 RESERVOIR AVE SUITE 201
City CRANSTON
State RI
ZIP 02920
Phone 401 943-1300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director PAUL W. RODERICK

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