41D2260964 CLIA NUMBER - RHODE ISLAND VASCULAR CENTER, LLC

Laboratory Demographics

CLIA Number: 41D2260964

Facility Name: RHODE ISLAND VASCULAR CENTER, LLC

Facility Address:
70 KENYON AVE L60
WAKEFIELD, RI
ZIP 02879
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Facility Phone Number: 401 315-9575

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1427607332

Taxonomy: 2086S0129X - Surgery
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

CLIA Record

Field Name	Field Value
CLIA Number	41D2260964
LAB Type	Physician Office
Facility Name	RHODE ISLAND VASCULAR CENTER, LLC
Street	70 KENYON AVE L60
City	WAKEFIELD
State	RI
ZIP	02879
Phone	401 315-9575
CertificateType	4
CertificateEffectiveDate	5/25/2022
CertificateExpirationDate	5/24/2024
FacilityType	Waiver

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