41D1001082 CLIA NUMBER - KARDOUS PRIMARY CARE INC

Laboratory Demographics

  • CLIA Code: 41D1001082
  • Facility Name: KARDOUS PRIMARY CARE INC
  • Facility Address: 1145 RESERVOIR AVE SUITE 301
    CRANSTON, RI
    ZIP 02920
  • Facility Phone: 401 946-5001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANTIOAN KARDOUS MD
  • NPI Number: 1134102841
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 41D1001082
LAB Type Physician Office
Facility Name KARDOUS PRIMARY CARE INC
Street 1145 RESERVOIR AVE SUITE 301
City CRANSTON
State RI
ZIP 02920
Phone 401 946-5001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Physician Office
Lab Director ANTIOAN KARDOUS MD

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