30D2239749 CLIA NUMBER - NEURORESTORATIVE KING HOUSE

Laboratory Demographics

CLIA Code: 30D2239749
Facility Name: NEURORESTORATIVE KING HOUSE
Facility Address: 6 KING RD
CHICHESTER, NH
ZIP 03258
Facility Phone: 603 848-1435
Facility Type: Intermediate Care Facility for Mentally Retarded
Facility Type: Waiver
Lab Director: HEIDI DE KOK
NPI Number: 1386879096
Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	30D2239749
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	NEURORESTORATIVE KING HOUSE
Street	6 KING RD
City	CHICHESTER
State	NH
ZIP	03258
Phone	603 848-1435
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	10/14/2025
Certificate Expiration Date	10/13/2027
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	HEIDI DE KOK

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