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30D0086157 CLIA NUMBER - GRANITE VNA

Laboratory Demographics

CLIA Number: 30D0086157

Facility Name: GRANITE VNA

Facility Address:
30 PILLSBURY ST
CONCORD, NH
ZIP 03301
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Facility Phone Number: 603 224-4093

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1164425583

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 30D0086157
LAB Type Home Health Agency
Facility Name GRANITE VNA
Street 30 PILLSBURY ST
City CONCORD
State NH
ZIP 03301
Phone 603 224-4093
CertificateType 4
CertificateEffectiveDate 4/28/2023
CertificateExpirationDate 4/27/2025
FacilityType Waiver

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