41D2285670 CLIA NUMBER - SOUTHERN NEW ENGLAND REGIONAL CANCER CENTER, LLC

Laboratory Demographics

CLIA Number: 41D2285670

Facility Name: SOUTHERN NEW ENGLAND REGIONAL CANCER CENTER, LLC

Facility Address:
115 CASS AVENUE SUITE 1A
WOONSOCKET, RI
ZIP 02895
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Facility Phone Number: 401 356-1701

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1134109697

Taxonomy: 2085R0001X - Radiology
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.

CLIA Record

Field Name	Field Value
CLIA Number	41D2285670
LAB Type	Physician Office
Facility Name	SOUTHERN NEW ENGLAND REGIONAL CANCER CENTER, LLC
Street	115 CASS AVENUE SUITE 1A
City	WOONSOCKET
State	RI
ZIP	02895
Phone	401 356-1701
CertificateType	4
CertificateEffectiveDate	7/17/2023
CertificateExpirationDate	7/16/2025
FacilityType	Waiver

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