30D0883291 CLIA NUMBER - PLYMOUTH PEDIATRIC & ADOLESCENT MEDICINE

Laboratory Demographics

  • CLIA Code: 30D0883291
  • Facility Name: PLYMOUTH PEDIATRIC & ADOLESCENT MEDICINE
  • Facility Address: 71 HIGHLAND ST
    PLYMOUTH, NH
    ZIP 03264
  • Facility Phone: 603 536-3700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERIC SHAMANSKY
  • NPI Number: 1326587635
  • Taxonomy: 261QR1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 30D0883291
LAB Type Physician Office
Facility Name PLYMOUTH PEDIATRIC & ADOLESCENT MEDICINE
Street 71 HIGHLAND ST
City PLYMOUTH
State NH
ZIP 03264
Phone 603 536-3700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2025
Certificate Expiration Date 10/22/2027
Facility Type Physician Office
Lab Director ERIC SHAMANSKY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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