22D2202534 CLIA NUMBER - WILLOWBROOK MANOR REST HOME

Laboratory Demographics

  • CLIA Code: 22D2202534
  • Facility Name: WILLOWBROOK MANOR REST HOME
  • Facility Address: 71 UNION STREET
    MILLIS, MA
    ZIP 02054
  • Facility Phone: 508 376-5083
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: HEMANTH HARI
  • NPI Number: 1134549645
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 22D2202534
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WILLOWBROOK MANOR REST HOME
Street 71 UNION STREET
City MILLIS
State MA
ZIP 02054
Phone 508 376-5083
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2024
Certificate Expiration Date 11/29/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director HEMANTH HARI

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This page was last updated on: 6/4/2025