22D0071277 CLIA NUMBER - ANDOVER MANOR REHAB AND NURSING LLC

Laboratory Demographics

  • CLIA Code: 22D0071277
  • Facility Name: ANDOVER MANOR REHAB AND NURSING LLC
  • Facility Address: 89 MORTON ST
    ANDOVER, MA
    ZIP 01810
  • Facility Phone: 845 414-3300
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHAIM MILLMAN
  • NPI Number: 1790967511
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 22D0071277
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ANDOVER MANOR REHAB AND NURSING LLC
Street 89 MORTON ST
City ANDOVER
State MA
ZIP 01810
Phone 845 414-3300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CHAIM MILLMAN

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This page was last updated on: 9/29/2025