41D2074379 CLIA NUMBER - TRI-COUNTY COMMUNITY HEALTH CENTER OF NORTH PROVIDENCE

Laboratory Demographics

CLIA Code: 41D2074379
Facility Name: TRI-COUNTY COMMUNITY HEALTH CENTER OF NORTH PROVIDENCE
Facility Address: 33 MAPLE AVENUE
NORTH PROVIDENCE, RI
ZIP 02911
Facility Phone: 401 351-1900
Facility Type: Federally Qualified Health Center
Facility Type: Microscopy
Lab Director: WILFREDO GIORDANO-PEREZ
NPI Number: 1912328600
Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name	Field Value
CLIA Number	41D2074379
LAB Type	Federally Qualified Health Center
Facility Name	TRI-COUNTY COMMUNITY HEALTH CENTER OF NORTH PROVIDENCE
Street	33 MAPLE AVENUE
City	NORTH PROVIDENCE
State	RI
ZIP	02911
Phone	401 351-1900
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	3/7/2024
Certificate Expiration Date	3/6/2026
Facility Type	Federally Qualified Health Center
Lab Director	WILFREDO GIORDANO-PEREZ

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