41D0915635 CLIA NUMBER - SCMG NEPHROLOGY & HYPERTENSION WAKEFIELD

Laboratory Demographics

  • CLIA Code: 41D0915635
  • Facility Name: SCMG NEPHROLOGY & HYPERTENSION WAKEFIELD
  • Facility Address: 70 KENYON AVENUE STE 326
    WAKEFIELD, RI
    ZIP 02879
  • Facility Phone: 401 788-1918
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARK J. MANCINI
  • NPI Number: 1740216035
  • Taxonomy: 213ES0103X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 41D0915635
LAB Type Physician Office
Facility Name SCMG NEPHROLOGY & HYPERTENSION WAKEFIELD
Street 70 KENYON AVENUE STE 326
City WAKEFIELD
State RI
ZIP 02879
Phone 401 788-1918
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/4/2024
Certificate Expiration Date 6/3/2026
Facility Type Physician Office
Lab Director MARK J. MANCINI

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