30D2158180 CLIA NUMBER - MW WELLNESS VENTURES I, LLC

Laboratory Demographics

  • CLIA Code: 30D2158180
  • Facility Name: MW WELLNESS VENTURES I, LLC
  • Facility Address: 24 ORCHARD VIEW DR, STE 2
    LONDONDERRY, NH
    ZIP 03053
  • Facility Phone: 603 782-9081
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JANA GOICH
  • NPI Number: 1023511763
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 30D2158180
LAB Type Practitioner Other
Facility Name MW WELLNESS VENTURES I, LLC
Street 24 ORCHARD VIEW DR, STE 2
City LONDONDERRY
State NH
ZIP 03053
Phone 603 782-9081
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2024
Certificate Expiration Date 11/20/2026
Facility Type Practitioner Other
Lab Director JANA GOICH

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