NPIMap

Organization Active NPI

The Commonwealth of Massachusetts

Doing business as Childhood Lead Screening Laboratory

  • Clinical Medical Laboratory
  • Boston, MA
National Provider Identifier
1053463448
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
NA Issued in MA
Legal business name
THE COMMONWEALTH OF MASSACHUSETTS
Doing business as
Childhood Lead Screening Laboratory
Practice address
305 South St
Boston, MA 02130-3515
Phone
(617) 983-6668
NPI assigned
Jan 17, 2007
Last updated
May 18, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
THE COMMONWEALTH OF MASSACHUSETTSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Matthew Courchene
Title
Chief Financial Officer
Phone
(617) 624-5309

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NA MA Primary

Addresses

Primary practice location

305 South St
Boston, MA 02130-3515

Mailing address

305 South St
Boston, MA 02130-3515
Phone (617) 983-6668

Other identifiers 6

IdentifierTypeStateIssuer
800470OtherHEALTH PILGRIM HEALTH PLA
0805998MedicaidMA
804460OtherTUFTS HEALTH PLAN
BOSTON HEALTHNETOther20611
32545OtherCHILDRENS MEDICAL SECURIT
228421OtherMABLUE CROSS OF MASS

Other names 1

  • Childhood Lead Screening Laboratory Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230519000033 MA Part B Supplier - Independent Clinical Laboratory 8820906860 Practice locations: Boston, MA

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Quincy Mental Health Center147 organizations share this tax ID, including this one
Part of
Quincy Mental Health Center

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

305 South St
Jamaica Plain, MA 02130
Phone (617) 983-6200

Ownership & related parties

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tewksbury HospitalTewksbury, MA, CCN 222003 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966
Lemuel Shattuck HospitalJamaica Plain, MA, CCN 222006 Hospital Operational/Managerial Control (100%) Jul 1, 1966
Dr. John C Corrigan Mental Health CenterFall River, MA, CCN 224028 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 2, 1989
Solomon Carter Fuller Mental Health CenterBoston, MA, CCN 224040 Hospital Operational/Managerial Control (100%) Dec 26, 2008
Worcester Recovery Center and HospitalWorcester, MA, CCN 224032 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 17, 1992
Cape Cod and the Islands Mental Health CenterPocasset, MA, CCN 224031 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 2, 1989
Taunton State HospitalTaunton, MA, CCN 224001 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1986
Massachusetts Veterans' Home in ChelseaChelsea, MA, CCN 225110 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 1, 2023
Jul 1, 1966
Massachusetts Veterans' Home of HolyokeHolyoke, MA, CCN 225786 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 6, 2025
May 6, 2025

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779062400000",
    "number": "1053463448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 SOUTH ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021303515",
            "telephone_number": "617-983-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 SOUTH ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021303515",
            "telephone_number": "617-983-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE COMMONWEALTH OF MASSACHUSETTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE COMMONWEALTH OF MASSACHUSETTS",
        "enumeration_date": "2007-01-17",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A",
        "authorized_official_last_name": "COURCHENE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "617-624-5309"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MA",
            "license": "NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PILGRIM HEALTH PLA",
            "identifier": "800470",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0805998",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "804460",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "20611",
            "identifier": "BOSTON HEALTHNET",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDRENS MEDICAL SECURIT",
            "identifier": "32545",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF  MASS",
            "identifier": "228421",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Childhood Lead Screening Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.