41D0950832 CLIA NUMBER - JAMES BONNER MD/ADMINISTRATIVE SVC GROUP

Laboratory Demographics

  • CLIA Code: 41D0950832
  • Facility Name: JAMES BONNER MD/ADMINISTRATIVE SVC GROUP
  • Facility Address: 1150 RESERVOIR AVE SUITE 205
    CRANSTON, RI
    ZIP 02920
  • Facility Phone: 401 943-9222
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES BONNER MD
  • NPI Number: 1083754717
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 41D0950832
LAB Type Physician Office
Facility Name JAMES BONNER MD/ADMINISTRATIVE SVC GROUP
Street 1150 RESERVOIR AVE SUITE 205
City CRANSTON
State RI
ZIP 02920
Phone 401 943-9222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2025
Certificate Expiration Date 1/18/2027
Facility Type Physician Office
Lab Director JAMES BONNER MD

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