30D2202187 CLIA NUMBER - BRUCE D LATHAM, DO, PA

Laboratory Demographics

  • CLIA Code: 30D2202187
  • Facility Name: BRUCE D LATHAM, DO, PA
  • Facility Address: 66 MAIN ST
    CONWAY, NH
    ZIP 03818
  • Facility Phone: 603 323-6199
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRUCE D. LATHAM
  • NPI Number: 1356302491
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 30D2202187
LAB Type Physician Office
Facility Name BRUCE D LATHAM, DO, PA
Street 66 MAIN ST
City CONWAY
State NH
ZIP 03818
Phone 603 323-6199
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/25/2024
Certificate Expiration Date 11/24/2026
Facility Type Physician Office
Lab Director BRUCE D. LATHAM

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