41D2168734 CLIA NUMBER - CHARTERCARE MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 41D2168734
  • Facility Name: CHARTERCARE MEDICAL ASSOCIATES
  • Facility Address: 50 MAUDE STREET 4TH FLOOR
    PROVIDENCE, RI
    ZIP 02908
  • Facility Phone: 401 519-3332
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANN G. BAUMAN MD
  • NPI Number: 1437544111
  • Taxonomy: 261QI0500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 41D2168734
LAB Type Physician Office
Facility Name CHARTERCARE MEDICAL ASSOCIATES
Street 50 MAUDE STREET 4TH FLOOR
City PROVIDENCE
State RI
ZIP 02908
Phone 401 519-3332
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2025
Certificate Expiration Date 7/8/2027
Facility Type Physician Office
Lab Director ANN G. BAUMAN MD

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