41D2064052 CLIA NUMBER - CODAC

Laboratory Demographics

  • CLIA Code: 41D2064052
  • Facility Name: CODAC
  • Facility Address: 1052 PARK AVE ATTN DIANE
    CRANSTON, RI
    ZIP 02910
  • Facility Phone: 401 275-5038
  • Facility Type: Other - OPIOID TREATMENT
  • Facility Type: Waiver
  • Lab Director: CATHERINE DEGOOD
  • NPI Number: 1558712034
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 41D2064052
LAB Type Other - OPIOID TREATMENT
Facility Name CODAC
Street 1052 PARK AVE ATTN DIANE
City CRANSTON
State RI
ZIP 02910
Phone 401 275-5038
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2025
Certificate Expiration Date 8/13/2027
Facility Type Other - OPIOID TREATMENT
Lab Director CATHERINE DEGOOD

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