30D1084788 CLIA NUMBER - TAMWORTH FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 30D1084788
  • Facility Name: TAMWORTH FAMILY MEDICINE
  • Facility Address: 577 WHITE MOUNTAIN HIGHWAY
    TAMWORTH, NH
    ZIP 03886
  • Facility Phone: 603 323-3311
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRIAN R. IRWIN DO
  • NPI Number: 1255587937
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 30D1084788
LAB Type Physician Office
Facility Name TAMWORTH FAMILY MEDICINE
Street 577 WHITE MOUNTAIN HIGHWAY
City TAMWORTH
State NH
ZIP 03886
Phone 603 323-3311
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 6/4/2024
Certificate Expiration Date 6/3/2026
Facility Type Physician Office
Lab Director BRIAN R. IRWIN DO

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