30D2040319 CLIA NUMBER - MONADNOCK ANTICOAGULATION CLINIC

Laboratory Demographics

  • CLIA Code: 30D2040319
  • Facility Name: MONADNOCK ANTICOAGULATION CLINIC
  • Facility Address: 454 OLD STREET RD, STE 301
    PETERBOROUGH, NH
    ZIP 03458
  • Facility Phone: 603 924-1713
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: LUCAS D. SHIPPEE
  • NPI Number: 1447476239
  • Taxonomy: 207VX0000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 30D2040319
LAB Type Ancillary Testing Site in Health Care Center
Facility Name MONADNOCK ANTICOAGULATION CLINIC
Street 454 OLD STREET RD, STE 301
City PETERBOROUGH
State NH
ZIP 03458
Phone 603 924-1713
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2024
Certificate Expiration Date 4/26/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director LUCAS D. SHIPPEE

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