30D2205762 CLIA NUMBER - LIGHTHOUSE SURGICAL SUITES, LLC

Laboratory Demographics

  • CLIA Code: 30D2205762
  • Facility Name: LIGHTHOUSE SURGICAL SUITES, LLC
  • Facility Address: 2 MARKET PL, STE #100
    HOLLIS, NH
    ZIP 03049
  • Facility Phone: 603 600-6175
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. JOSEPH KAVOLUS
  • NPI Number: 1932700085
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 30D2205762
LAB Type Ambulatory Surgery Center
Facility Name LIGHTHOUSE SURGICAL SUITES, LLC
Street 2 MARKET PL, STE #100
City HOLLIS
State NH
ZIP 03049
Phone 603 600-6175
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2024
Certificate Expiration Date 12/15/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. JOSEPH KAVOLUS

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