41D2113059 CLIA NUMBER - MARK E CLARKE, NP, LLC

Laboratory Demographics

  • CLIA Code: 41D2113059
  • Facility Name: MARK E CLARKE, NP, LLC
  • Facility Address: 600 PUTNUM PIKE STE 8
    GREENVILLE, RI
    ZIP 02828
  • Facility Phone: 401 349-4303
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MARK E. CLARKE NP
  • NPI Number: 1952756652
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 41D2113059
LAB Type Practitioner Other
Facility Name MARK E CLARKE, NP, LLC
Street 600 PUTNUM PIKE STE 8
City GREENVILLE
State RI
ZIP 02828
Phone 401 349-4303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2024
Certificate Expiration Date 5/15/2026
Facility Type Practitioner Other
Lab Director MARK E. CLARKE NP

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