22D0916109 CLIA NUMBER - PENACOOK PLACE, INC

Laboratory Demographics

  • CLIA Code: 22D0916109
  • Facility Name: PENACOOK PLACE, INC
  • Facility Address: 150 WATER ST
    HAVERHILL, MA
    ZIP 01830
  • Facility Phone: 978 374-0707
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: VANESSA BRETTON
  • NPI Number: 1134107196
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 22D0916109
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PENACOOK PLACE, INC
Street 150 WATER ST
City HAVERHILL
State MA
ZIP 01830
Phone 978 374-0707
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2024
Certificate Expiration Date 6/13/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director VANESSA BRETTON

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