30D2175175 CLIA NUMBER - ACTIVMED PRACTICES & RESEARCH, LLC

Laboratory Demographics

  • CLIA Code: 30D2175175
  • Facility Name: ACTIVMED PRACTICES & RESEARCH, LLC
  • Facility Address: 155 BORTHWICK AVE, STE 250
    PORTSMOUTH, NH
    ZIP 03801
  • Facility Phone: 978 655-7155
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ABEL D. JARELL
  • NPI Number: 1700425253
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 30D2175175
LAB Type Physician Office
Facility Name ACTIVMED PRACTICES & RESEARCH, LLC
Street 155 BORTHWICK AVE, STE 250
City PORTSMOUTH
State NH
ZIP 03801
Phone 978 655-7155
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Physician Office
Lab Director ABEL D. JARELL

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