41D2294693 CLIA NUMBER - PRIMA CARE AMBULATORY SURGERY CENTER

Laboratory Demographics

CLIA Number: 41D2294693

Facility Name: PRIMA CARE AMBULATORY SURGERY CENTER

Facility Address:
1040 CHARLES ST
NORTH PROVIDENCE, RI
ZIP 02904
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Facility Phone Number: 508 676-3292

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1083158265

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	41D2294693
LAB Type	Ambulatory Surgery Center
Facility Name	PRIMA CARE AMBULATORY SURGERY CENTER
Street	1040 CHARLES ST
City	NORTH PROVIDENCE
State	RI
ZIP	02904
Phone	508 676-3292
CertificateType	4
CertificateEffectiveDate	11/29/2023
CertificateExpirationDate	11/28/2025
FacilityType	Waiver

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