41D1092192 CLIA NUMBER - INDEPENDENCE HEALTH SERVICES LLC

Laboratory Demographics

  • CLIA Code: 41D1092192
  • Facility Name: INDEPENDENCE HEALTH SERVICES LLC
  • Facility Address: 1179 ELMWOOD AVENUE
    PROVIDENCE, RI
    ZIP 02907
  • Facility Phone: 401 437-8337
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: MS. JOAN T. HANRAHAN RN
  • NPI Number: 1912172974
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 41D1092192
LAB Type Home Health Agency
Facility Name INDEPENDENCE HEALTH SERVICES LLC
Street 1179 ELMWOOD AVENUE
City PROVIDENCE
State RI
ZIP 02907
Phone 401 437-8337
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2024
Certificate Expiration Date 11/18/2026
Facility Type Home Health Agency
Lab Director MS. JOAN T. HANRAHAN RN

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