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41D2074147 CLIA NUMBER - MINUTECLINIC DIAGNOSTIC OF RHODE ISLAND, LLC (CLINIC #00590)

Laboratory Demographics

CLIA Number: 41D2074147

Facility Name: MINUTECLINIC DIAGNOSTIC OF RHODE ISLAND, LLC (CLINIC #00590)

Facility Address:
1054 CASS AVE
WOONSOCKET, RI
ZIP 02895
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Facility Phone Number: 866 389-2727

Facility Type: Other - LIMITED SERVICE CLINIC

Certificate Type: Waiver
NPI Number: 1073780730

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name Field Value
CLIA Number 41D2074147
LAB Type Other - LIMITED SERVICE CLINIC
Facility Name MINUTECLINIC DIAGNOSTIC OF RHODE ISLAND, LLC (CLINIC #00590)
Street 1054 CASS AVE
City WOONSOCKET
State RI
ZIP 02895
Phone 866 389-2727
CertificateType 4
CertificateEffectiveDate 3/3/2024
CertificateExpirationDate 3/2/2026
FacilityType Waiver

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This page was last updated on: 4/23/2024