41D0912665 CLIA NUMBER - BERKSHIRE PLACE

Laboratory Demographics

  • CLIA Code: 41D0912665
  • Facility Name: BERKSHIRE PLACE
  • Facility Address: 455 DOUGLAS AVENUE
    PROVIDENCE, RI
    ZIP 02908
  • Facility Phone: 401 553-8600
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CAITLIN MARABELLO
  • NPI Number: 1457463077
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 41D0912665
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BERKSHIRE PLACE
Street 455 DOUGLAS AVENUE
City PROVIDENCE
State RI
ZIP 02908
Phone 401 553-8600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2024
Certificate Expiration Date 3/7/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CAITLIN MARABELLO

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