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CODMAN SQUARE HEALTH CENTER
NPI 1003770736
Clinic/Center - Community Health in Randolph, MA

Active since December 16, 2025CLIA 22D0666316 · Accreditation
42 HIGHLAND AVENUE, RANDOLPH, MA 02368(617) 825-9660(617) 288-7898 Get Directions Write a Review

NPPES record last updated: December 16, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Codman Square Health Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CODMAN SQUARE HEALTH CENTER (NPI 1003770736) is a healthcare organization registered as a community health in Randolph, Massachusetts and active in the NPI registry since December 2025. The organization holds an CLIA Accreditation certificate valid through November 17, 2027 and lists Guy Fish, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003770736
Entity TypeOrganization
Primary Taxonomy261QC1500X
Legal Business NameCODMAN SQUARE HEALTH CENTER
Location Address42 HIGHLAND AVENUERandolph, MA 02368-0000
Mailing Address637 Washington StDorchester, MA 02124-3510 · (617) 825-9660 · Fax (617) 288-7898
Phone(617) 825-9660
Fax(617) 288-7898
Organization SubpartNo
Authorized OfficialGuy FishCeo · (617) 825-9660
Enumeration DateDecember 16, 2025
NPPES CertifiedDecember 15, 2025
✔ NPI 1003770736 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Community HealthAmbulatory Health Care Facilities
Taxonomy Code261QC1500X
42 HIGHLAND AVENUE, Randolph, MA 02368
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 22D0666316

Codman Square Health Center · Dorchester, MA
Active · expires Nov 17, 2027
CLIA Number22D0666316
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateNovember 18, 2025
Certificate Expiration DateNovember 17, 2027
Laboratory DirectorKwaku Twum
Laboratory Phone(617) 822-8111
Laboratory LocationCodman Square Health Center637 Washington Street 1st Floor Laboratory, Dorchester, MA 02124
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Codman Square Health Center's NPI number?

The NPI number for Codman Square Health Center is 1003770736. It was assigned to this organization in the NPPES registry on December 16, 2025.

Where is Codman Square Health Center located?

Codman Square Health Center is located at 42 Highland Avenue, Randolph, MA 02368. The listed phone number is (617) 825-9660.

What is Codman Square Health Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

Does Codman Square Health Center hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 22D0666316) is associated with this NPI, valid through November 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Codman Square Health Center was last updated on December 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.