41D2142695 CLIA NUMBER - UNIVERSITY ORTHOPEDICS EAST BAY SURGERY CENTER

Laboratory Demographics

CLIA Number: 41D2142695

Facility Name: UNIVERSITY ORTHOPEDICS EAST BAY SURGERY CENTER

Facility Address:
1 KETTLE POINT AVE SUITE 200
EAST PROVIDENCE, RI
ZIP 02914
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Facility Phone Number: 401 443-4230

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1073039657

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	41D2142695
LAB Type	Ambulatory Surgery Center
Facility Name	UNIVERSITY ORTHOPEDICS EAST BAY SURGERY CENTER
Street	1 KETTLE POINT AVE SUITE 200
City	EAST PROVIDENCE
State	RI
ZIP	02914
Phone	401 443-4230
CertificateType	4
CertificateEffectiveDate	1/18/2024
CertificateExpirationDate	1/17/2026
FacilityType	Waiver

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