22D2130692 CLIA NUMBER - WASHBURN HOUSE

Laboratory Demographics

CLIA Number: 22D2130692

Facility Name: WASHBURN HOUSE

Facility Address:
1183 MAIN STREET
WORCESTER, MA
ZIP 01603
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Facility Phone Number: 860 324-9313

Facility Type: Other - DETOX & RESIDENTIAL

Certificate Type: Waiver

NPI Number: 1912486622

Taxonomy: -

CLIA Record

Field Name	Field Value
CLIA Number	22D2130692
LAB Type	Other - DETOX & RESIDENTIAL
Facility Name	WASHBURN HOUSE
Street	1183 MAIN STREET
City	WORCESTER
State	MA
ZIP	01603
Phone	860 324-9313
CertificateType	4
CertificateEffectiveDate	5/16/2023
CertificateExpirationDate	5/15/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024