22D2287002 CLIA NUMBER - RECOVERY HEALTH PROFESSIONAL LLC

Laboratory Demographics

CLIA Number: 22D2287002

Facility Name: RECOVERY HEALTH PROFESSIONAL LLC

Facility Address:
171 DWIGHT RD STE 102
LONGMEADOW, MA
ZIP 01106
Get Directions

Facility Phone Number: 413 384-2494

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1780277368

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	22D2287002
LAB Type	Practitioner Other
Facility Name	RECOVERY HEALTH PROFESSIONAL LLC
Street	171 DWIGHT RD STE 102
City	LONGMEADOW
State	MA
ZIP	01106
Phone	413 384-2494
CertificateType	4
CertificateEffectiveDate	8/8/2023
CertificateExpirationDate	8/7/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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