30D0935199 CLIA NUMBER - ELLIOT PHYSICIAN NETWORK POINT OF CARE TESTING

Laboratory Demographics

  • CLIA Code: 30D0935199
  • Facility Name: ELLIOT PHYSICIAN NETWORK POINT OF CARE TESTING
  • Facility Address: 275 MAMMOTH RD, STE 3
    MANCHESTER, NH
    ZIP 03103
  • Facility Phone: 603 663-3590
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KEVIN DESROSIERS
  • NPI Number: 1154310910
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 30D0935199
LAB Type Physician Office
Facility Name ELLIOT PHYSICIAN NETWORK POINT OF CARE TESTING
Street 275 MAMMOTH RD, STE 3
City MANCHESTER
State NH
ZIP 03103
Phone 603 663-3590
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/22/2025
Certificate Expiration Date 10/21/2027
Facility Type Physician Office
Lab Director KEVIN DESROSIERS

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