22D0665871 CLIA NUMBER - HOLYOKE CAPITAL JV LLC DBA MIRAVISTA BEHAVIORAL HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 22D0665871
  • Facility Name: HOLYOKE CAPITAL JV LLC DBA MIRAVISTA BEHAVIORAL HEALTH CENTER
  • Facility Address: 1233 MAIN STREET
    HOLYOKE, MA
    ZIP 01040
  • Facility Phone: 978 877-9938
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: MS. ANA WOLANIN
  • NPI Number: 1649856618
  • Taxonomy: 283Q00000X - Psychiatric Hospital

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CLIA Record

Field Name Field Value
CLIA Number 22D0665871
LAB Type Hospital
Facility Name HOLYOKE CAPITAL JV LLC DBA MIRAVISTA BEHAVIORAL HEALTH CENTER
Street 1233 MAIN STREET
City HOLYOKE
State MA
ZIP 01040
Phone 978 877-9938
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Hospital
Lab Director MS. ANA WOLANIN

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