22D2198059 CLIA NUMBER - DEVEREUX ADVANCED BEHAVIORAL HEALTH

Laboratory Demographics

  • CLIA Code: 22D2198059
  • Facility Name: DEVEREUX ADVANCED BEHAVIORAL HEALTH
  • Facility Address: 60 MILES RD
    RUTLAND, MA
    ZIP 01543
  • Facility Phone: 508 886-4746
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: JONATHAN M. JACOBSON
  • NPI Number: 1013397843
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 22D2198059
LAB Type School/Student Health Service
Facility Name DEVEREUX ADVANCED BEHAVIORAL HEALTH
Street 60 MILES RD
City RUTLAND
State MA
ZIP 01543
Phone 508 886-4746
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2024
Certificate Expiration Date 10/28/2026
Facility Type School/Student Health Service
Lab Director JONATHAN M. JACOBSON

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