30D1056306 CLIA NUMBER - GOFFSTOWN FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 30D1056306
  • Facility Name: GOFFSTOWN FAMILY PRACTICE
  • Facility Address: 17A TATRO DR
    GOFFSTOWN, NH
    ZIP 03045
  • Facility Phone: 603 314-4500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHEN MICHAUD
  • NPI Number: 1518591395
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 30D1056306
LAB Type Physician Office
Facility Name GOFFSTOWN FAMILY PRACTICE
Street 17A TATRO DR
City GOFFSTOWN
State NH
ZIP 03045
Phone 603 314-4500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2024
Certificate Expiration Date 4/6/2026
Facility Type Physician Office
Lab Director STEPHEN MICHAUD

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