22D2255437 CLIA NUMBER - COMMONWEALTH HOSPICE LLC

Laboratory Demographics

  • CLIA Code: 22D2255437
  • Facility Name: COMMONWEALTH HOSPICE LLC
  • Facility Address: 821 DANIEL SHAYS HWY
    ATHOL, MA
    ZIP 01331
  • Facility Phone: 978 947-7870
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: TANYA BROUILLARD
  • NPI Number: 1497356091
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 22D2255437
LAB Type Hospice
Facility Name COMMONWEALTH HOSPICE LLC
Street 821 DANIEL SHAYS HWY
City ATHOL
State MA
ZIP 01331
Phone 978 947-7870
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Hospice
Lab Director TANYA BROUILLARD

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