30D0085139 CLIA NUMBER - MAIN STREET PEDIATRIC & ADOLESCENT MEDICINE

Laboratory Demographics

  • CLIA Code: 30D0085139
  • Facility Name: MAIN STREET PEDIATRIC & ADOLESCENT MEDICINE
  • Facility Address: 280 MAIN STREET SUITE 410
    NASHUA, NH
    ZIP 03060
  • Facility Phone: 603 595-7388
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUSAN L. MCNAMEE
  • NPI Number: 1154752392
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 30D0085139
LAB Type Physician Office
Facility Name MAIN STREET PEDIATRIC & ADOLESCENT MEDICINE
Street 280 MAIN STREET SUITE 410
City NASHUA
State NH
ZIP 03060
Phone 603 595-7388
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2025
Certificate Expiration Date 5/25/2027
Facility Type Physician Office
Lab Director SUSAN L. MCNAMEE

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