41D2273558 CLIA NUMBER - DIVERSITY COUNSELING LLC

Laboratory Demographics

  • CLIA Code: 41D2273558
  • Facility Name: DIVERSITY COUNSELING LLC
  • Facility Address: 111 WAYLAND AVENUE
    PROVIDENCE, RI
    ZIP 02906
  • Facility Phone: 401 396-7649
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: JOSE G. CRUZ RODRIGUEZ
  • NPI Number: 1033868930
  • Taxonomy: 101YA0400X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 41D2273558
LAB Type Independent
Facility Name DIVERSITY COUNSELING LLC
Street 111 WAYLAND AVENUE
City PROVIDENCE
State RI
ZIP 02906
Phone 401 396-7649
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type Independent
Lab Director JOSE G. CRUZ RODRIGUEZ

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