30D0979580 CLIA NUMBER - MID-STATE HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 30D0979580
  • Facility Name: MID-STATE HEALTH CENTER
  • Facility Address: 100 ROBIE RD
    BRISTOL, NH
    ZIP 03222
  • Facility Phone: 603 744-6200
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Certificate of Compliance
  • Lab Director: KATHERINE MARIE GAGAN
  • NPI Number: 1336262195
  • Taxonomy: 103TF0000X - Psychologist

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CLIA Record

Field Name Field Value
CLIA Number 30D0979580
LAB Type Federally Qualified Health Center
Facility Name MID-STATE HEALTH CENTER
Street 100 ROBIE RD
City BRISTOL
State NH
ZIP 03222
Phone 603 744-6200
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 6/27/2025
Certificate Expiration Date 6/26/2027
Facility Type Federally Qualified Health Center
Lab Director KATHERINE MARIE GAGAN

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