Healthcare Provider Details

I. General information

NPI: 1639091689
Provider Name (Legal Business Name): CLEAR CHOICE COLLECTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 ASHBY STATE RD STE 101L
FITCHBURG MA
01420-2090
US

IV. Provider business mailing address

47 ASHBY STATE RD STE 101L
FITCHBURG MA
01420-2090
US

V. Phone/Fax

Practice location:
  • Phone: 774-364-0607
  • Fax: 774-366-0051
Mailing address:
  • Phone: 774-364-0607
  • Fax: 774-366-0051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: IRIS N SIMONGKHOUN
Title or Position: PHLEBOTOMIST
Credential: RMA
Phone: 774-364-0607