41D1065518 CLIA NUMBER - HERITAGE MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 41D1065518
  • Facility Name: HERITAGE MEDICAL ASSOCIATES
  • Facility Address: 131 BEECHWOOD AVENUE
    PAWTUCKET, RI
    ZIP 02860
  • Facility Phone: 401 475-1999
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN P. MISKOVSKY MD
  • NPI Number: 1003982547
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 41D1065518
LAB Type Physician Office
Facility Name HERITAGE MEDICAL ASSOCIATES
Street 131 BEECHWOOD AVENUE
City PAWTUCKET
State RI
ZIP 02860
Phone 401 475-1999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2025
Certificate Expiration Date 3/4/2027
Facility Type Physician Office
Lab Director JOHN P. MISKOVSKY MD

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