22D2053226 CLIA NUMBER - INDEPENDENT AT HOME LLC

Laboratory Demographics

  • CLIA Code: 22D2053226
  • Facility Name: INDEPENDENT AT HOME LLC
  • Facility Address: 55 CHERRY STREET 3RD FLOOR
    BROCKTON, MA
    ZIP 02301
  • Facility Phone: 800 593-2454
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: MARIE NELSON
  • NPI Number: 1124238324
  • Taxonomy: 251V00000X - Voluntary or Charitable

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CLIA Record

Field Name Field Value
CLIA Number 22D2053226
LAB Type Home Health Agency
Facility Name INDEPENDENT AT HOME LLC
Street 55 CHERRY STREET 3RD FLOOR
City BROCKTON
State MA
ZIP 02301
Phone 800 593-2454
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2025
Certificate Expiration Date 1/27/2027
Facility Type Home Health Agency
Lab Director MARIE NELSON

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