41D1101912 CLIA NUMBER - JOHN MCGONIGLE MD

Laboratory Demographics

  • CLIA Code: 41D1101912
  • Facility Name: JOHN MCGONIGLE MD
  • Facility Address: 201 WATERMAN AVE
    EAST PROVIDENCE, RI
    ZIP 02914
  • Facility Phone: 401 447-2464
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN MCGONIGLE MD
  • NPI Number: 1982717807
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 41D1101912
LAB Type Physician Office
Facility Name JOHN MCGONIGLE MD
Street 201 WATERMAN AVE
City EAST PROVIDENCE
State RI
ZIP 02914
Phone 401 447-2464
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2025
Certificate Expiration Date 7/7/2027
Facility Type Physician Office
Lab Director JOHN MCGONIGLE MD

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