| CLIA License | 22D0069726 | 
| CAP | 3733701 | 
| State of California | CDS-00800075 | 
| State of Maryland | 548 | 
| State of Massachusetts | 5879 | 
| State of New York Department of Health | 4118 | 
| State of Pennsylvania | 25752A | 
| State of Rhode Island | LCO00856 | 
| Federal Tax ID | 31-1805826 | 
| NPI Number | 1023063062 | 
| Medicare License | S300288100 |