41D2300939 CLIA NUMBER - NORTH PROVIDENCE PEDIATRICS INC

Laboratory Demographics

  • CLIA Code: 41D2300939
  • Facility Name: NORTH PROVIDENCE PEDIATRICS INC
  • Facility Address: 1169 MINERAL SPRING AVE
    NORTH PROVIDENCE, RI
    ZIP 02904
  • Facility Phone: 401 725-4176
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOREEN M. CIANCAGLINI
  • NPI Number: 1992825293
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 41D2300939
LAB Type Physician Office
Facility Name NORTH PROVIDENCE PEDIATRICS INC
Street 1169 MINERAL SPRING AVE
City NORTH PROVIDENCE
State RI
ZIP 02904
Phone 401 725-4176
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2024
Certificate Expiration Date 3/18/2026
Facility Type Physician Office
Lab Director DOREEN M. CIANCAGLINI

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