41D0940029 CLIA NUMBER - TIVERTON PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 41D0940029
  • Facility Name: TIVERTON PRIMARY CARE
  • Facility Address: 821 MAIN RD
    TIVERTON, RI
    ZIP 02878
  • Facility Phone: 401 625-1001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHARLES H. CUMMINGS
  • NPI Number: 1760593297
  • Taxonomy: 1041C0700X - Social Worker

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CLIA Record

Field Name Field Value
CLIA Number 41D0940029
LAB Type Physician Office
Facility Name TIVERTON PRIMARY CARE
Street 821 MAIN RD
City TIVERTON
State RI
ZIP 02878
Phone 401 625-1001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2024
Certificate Expiration Date 2/3/2026
Facility Type Physician Office
Lab Director CHARLES H. CUMMINGS

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