41D2197865 CLIA NUMBER - PACIFICA SENIOR LIVIGN VICTORIA COURT

Laboratory Demographics

  • CLIA Code: 41D2197865
  • Facility Name: PACIFICA SENIOR LIVIGN VICTORIA COURT
  • Facility Address: 55 OAKLAWN AVE
    CRANSTON, RI
    ZIP 02920
  • Facility Phone: 401 946-5522
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: RHODA T. SMITH
  • NPI Number: 1649590977
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 41D2197865
LAB Type Assisted Living Facility
Facility Name PACIFICA SENIOR LIVIGN VICTORIA COURT
Street 55 OAKLAWN AVE
City CRANSTON
State RI
ZIP 02920
Phone 401 946-5522
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Assisted Living Facility
Lab Director RHODA T. SMITH

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