41D2117309 CLIA NUMBER - PIER MEDICAL, INC

Laboratory Demographics

CLIA Number: 41D2117309

Facility Name: PIER MEDICAL, INC

Facility Address:
24 SALT POND ROAD SUITE H5
WAKEFIELD, RI
ZIP 02879
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Facility Phone Number: 401 789-2424

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1942655428

Taxonomy: 363LA2200X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	41D2117309
LAB Type	Practitioner Other
Facility Name	PIER MEDICAL, INC
Street	24 SALT POND ROAD SUITE H5
City	WAKEFIELD
State	RI
ZIP	02879
Phone	401 789-2424
CertificateType	4
CertificateEffectiveDate	8/15/2022
CertificateExpirationDate	8/14/2024
FacilityType	Waiver

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