41D0894561 CLIA NUMBER - CHILDRENS MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 41D0894561
  • Facility Name: CHILDRENS MEDICAL GROUP
  • Facility Address: 100 HIGHLAND AVENUE SUITE 201
    PROVIDENCE, RI
    ZIP 02906
  • Facility Phone: 401 633-1100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT E. EDEN MD
  • NPI Number: 1932117702
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 41D0894561
LAB Type Physician Office
Facility Name CHILDRENS MEDICAL GROUP
Street 100 HIGHLAND AVENUE SUITE 201
City PROVIDENCE
State RI
ZIP 02906
Phone 401 633-1100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2025
Certificate Expiration Date 2/14/2027
Facility Type Physician Office
Lab Director ROBERT E. EDEN MD

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