41D0972319 CLIA NUMBER - ANCHOR MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 41D0972319
  • Facility Name: ANCHOR MEDICAL ASSOCIATES
  • Facility Address: 180 CORLISS ST STE
    PROVIDENCE, RI
    ZIP 02904
  • Facility Phone: 701 793-8400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DIANE R. SIEDLECKI
  • NPI Number: 1205832029
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 41D0972319
LAB Type Physician Office
Facility Name ANCHOR MEDICAL ASSOCIATES
Street 180 CORLISS ST STE
City PROVIDENCE
State RI
ZIP 02904
Phone 701 793-8400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2024
Certificate Expiration Date 4/4/2026
Facility Type Physician Office
Lab Director DIANE R. SIEDLECKI

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