30D2273642 CLIA NUMBER - PENACOOK ASSISTED LIVING FACILITY, INC

Laboratory Demographics

  • CLIA Code: 30D2273642
  • Facility Name: PENACOOK ASSISTED LIVING FACILITY, INC
  • Facility Address: 30 BOROUGH
    PENACOOK, NH
    ZIP 03303
  • Facility Phone: 603 753-9100
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CATIE T. GAUDREAULT
  • NPI Number: 1588742092
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 30D2273642
LAB Type Assisted Living Facility
Facility Name PENACOOK ASSISTED LIVING FACILITY, INC
Street 30 BOROUGH
City PENACOOK
State NH
ZIP 03303
Phone 603 753-9100
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 Assisted Living Facility
Lab Director CATIE T. GAUDREAULT

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