41D2266454 CLIA NUMBER - THUNDERMIST HEALTH CENTER OF SOUTH COUNTY - PEDIATRICS

Laboratory Demographics

  • CLIA Code: 41D2266454
  • Facility Name: THUNDERMIST HEALTH CENTER OF SOUTH COUNTY - PEDIATRICS
  • Facility Address: 360 KINGSTOWN ROAD STE 101
    NARRAGANSETT, RI
    ZIP 02882
  • Facility Phone: 401 789-6492
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: DAVID BOURASSA
  • NPI Number: 1265190292
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 41D2266454
LAB Type Federally Qualified Health Center
Facility Name THUNDERMIST HEALTH CENTER OF SOUTH COUNTY - PEDIATRICS
Street 360 KINGSTOWN ROAD STE 101
City NARRAGANSETT
State RI
ZIP 02882
Phone 401 789-6492
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/10/2024
Certificate Expiration Date 8/9/2026
Facility Type Federally Qualified Health Center
Lab Director DAVID BOURASSA

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