41D2248712 CLIA NUMBER - PROVIDENCE HOUSING AUTHORITY, THE

Laboratory Demographics

  • CLIA Code: 41D2248712
  • Facility Name: PROVIDENCE HOUSING AUTHORITY, THE
  • Facility Address: 100 BROAD STREET
    PROVIDENCE, RI
    ZIP 02903
  • Facility Phone: 401 709-1303
  • Facility Type: Other - AFFORDABLE HOUSING
  • Facility Type: Waiver
  • Lab Director: JACQUELINE I. MARINEZ
  • NPI Number: 1467864884
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 41D2248712
LAB Type Other - AFFORDABLE HOUSING
Facility Name PROVIDENCE HOUSING AUTHORITY, THE
Street 100 BROAD STREET
City PROVIDENCE
State RI
ZIP 02903
Phone 401 709-1303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2024
Certificate Expiration Date 1/14/2026
Facility Type Other - AFFORDABLE HOUSING
Lab Director JACQUELINE I. MARINEZ

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