41D1006190 CLIA NUMBER - PETTERUTI FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 41D1006190

Facility Name: PETTERUTI FAMILY PRACTICE

Facility Address:
250 CENTERVILLE RD BLDG E10
WARWICK, RI
ZIP 02886
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Facility Phone Number: 401 921-5934

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1417132549

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	41D1006190
LAB Type	Physician Office
Facility Name	PETTERUTI FAMILY PRACTICE
Street	250 CENTERVILLE RD BLDG E10
City	WARWICK
State	RI
ZIP	02886
Phone	401 921-5934
CertificateType	4
CertificateEffectiveDate	11/12/2022
CertificateExpirationDate	11/11/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024