41D2041521 CLIA NUMBER - LIFESPAN PHYSICIAN GROUP - OBSTETRICS & GYNECOLOGY

Laboratory Demographics

  • CLIA Code: 41D2041521
  • Facility Name: LIFESPAN PHYSICIAN GROUP - OBSTETRICS & GYNECOLOGY
  • Facility Address: 1377 SOUTH COUNTY TRAIL UNIT 2A
    EAST GREENWICH, RI
    ZIP 02818
  • Facility Phone: (401) 606-3000
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANNMARIE JURCZAK MD
  • NPI Number: 1174484216
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 41D2041521
LAB Type Physician Office
Facility Name LIFESPAN PHYSICIAN GROUP - OBSTETRICS & GYNECOLOGY
Street 1377 SOUTH COUNTY TRAIL UNIT 2A
City EAST GREENWICH
State RI
ZIP 02818
Phone 4016063000
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/25/2026
Certificate Expiration Date 2/24/2028
Facility Type Physician Office
Lab Director ANNMARIE JURCZAK MD

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This page was last updated on: 6/29/2026