41D0907240 CLIA NUMBER - BLACKSTONE VALLEY SURGICARE

Laboratory Demographics

  • CLIA Code: 41D0907240
  • Facility Name: BLACKSTONE VALLEY SURGICARE
  • Facility Address: 1526 ATWOOD AVE SUITE 300
    JOHNSTON, RI
    ZIP 02919
  • Facility Phone: 401 459-3800
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ANN L. DUGAN RN
  • NPI Number: 1528024171
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 41D0907240
LAB Type Ambulatory Surgery Center
Facility Name BLACKSTONE VALLEY SURGICARE
Street 1526 ATWOOD AVE SUITE 300
City JOHNSTON
State RI
ZIP 02919
Phone 401 459-3800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2023
Certificate Expiration Date 10/10/2025
Facility Type Ambulatory Surgery Center
Lab Director ANN L. DUGAN RN

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