Organization
THE COMMONWEALTH OF MASSACHUSETTS
Active
Parent organization
THE COMMONWEALTH OF MASSACHUSETTS
Other names
Childhood Lead Screening Laboratory
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE COMMONWEALTH OF MASSACHUSETTS
Authorized official
MATTHEW COURCHENE (CHIEF FINANCIAL OFFICER)
(617) 624-5309
Entity
Organization
Contact information
Practice address
305 SOUTH ST, BOSTON, MA 02130-3515
(617) 983-6668
Mailing address
305 SOUTH ST, BOSTON, MA 02130-3515
(617) 983-6668
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
NA
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0805998
—
MA
01
—
228421
BLUE CROSS OF MASS
MA
01
—
32545
CHILDRENS MEDICAL SECURIT
—
01
—
800470
HEALTH PILGRIM HEALTH PLA
—
01
—
804460
TUFTS HEALTH PLAN
—
01
—
BOSTON HEALTHNET
20611
—
Enumeration date
01/17/2007
Last updated
05/18/2026
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