30D2057716 CLIA NUMBER - PMC MEDICAL GROUP, LLC

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Laboratory Demographics

CLIA Number: 30D2057716

Facility Name: PMC MEDICAL GROUP, LLC

Facility Address:
22 BRIDGE ST
CONCORD, NH
ZIP 03301
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Facility Phone Number: 603 415-0330

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1396121240

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	30D2057716
LAB Type	Physician Office
Facility Name	PMC MEDICAL GROUP, LLC
Street	22 BRIDGE ST
City	CONCORD
State	NH
ZIP	03301
Phone	603 415-0330
CertificateType	4
CertificateEffectiveDate	4/23/2023
CertificateExpirationDate	4/22/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024