Upon the approval of the application for a license, the Department shall issue a clinic license to the applicant. Every license shall state the name and address of the clinic if either differs from that of the licensee; the period of licensure; the specific service(s) the clinic is licensed to deliver; and the name and address of any satellite clinic. In the case of a clinic providing mobile medical services, the license shall state the name and address of the clinic, including address of the administrative offices, if separate from the site(s) of service, and the name and address of the host locations.
105 CMR, § 140.120