41D1074873 CLIA NUMBER - KEITH L CALLAHAN MD PC

Laboratory Demographics

  • CLIA Code: 41D1074873
  • Facility Name: KEITH L CALLAHAN MD PC
  • Facility Address: 390 TOLL GATE ROAD, SUITE 108
    WARWICK, RI
    ZIP 02886
  • Facility Phone: 401 921-5672
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. KEITH L. CALLAHAN
  • NPI Number: 1629063219
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 41D1074873
LAB Type Physician Office
Facility Name KEITH L CALLAHAN MD PC
Street 390 TOLL GATE ROAD, SUITE 108
City WARWICK
State RI
ZIP 02886
Phone 401 921-5672
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2025
Certificate Expiration Date 10/8/2027
Facility Type Physician Office
Lab Director DR. KEITH L. CALLAHAN

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