30D2209653 CLIA NUMBER - SULLIVAN COUNTY DEPARTMENT OF CORRECTIONS

Laboratory Demographics

  • CLIA Code: 30D2209653
  • Facility Name: SULLIVAN COUNTY DEPARTMENT OF CORRECTIONS
  • Facility Address: 103 COUNTRY FARM RD
    CLAREMONT, NH
    ZIP 03743
  • Facility Phone: 603 542-8717
  • Facility Type: Other - CORRECTIONAL FACILITY
  • Facility Type: Waiver
  • Lab Director: TONIA C. BOWMAN
  • NPI Number: 1316172281
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 30D2209653
LAB Type Other - CORRECTIONAL FACILITY
Facility Name SULLIVAN COUNTY DEPARTMENT OF CORRECTIONS
Street 103 COUNTRY FARM RD
City CLAREMONT
State NH
ZIP 03743
Phone 603 542-8717
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2025
Certificate Expiration Date 1/14/2027
Facility Type Other - CORRECTIONAL FACILITY
Lab Director TONIA C. BOWMAN

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