30D2285429 CLIA NUMBER - CONVENIENTMD PRIMARY CARE MANCHESTER

Laboratory Demographics

CLIA Number: 30D2285429

Facility Name: CONVENIENTMD PRIMARY CARE MANCHESTER

Facility Address:
545 HOOKSETT RD, UNIT 1
MANCHESTER, NH
ZIP 03104
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Facility Phone Number: 603 255-4775

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1174238992

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 30D2285429
LAB Type Physician Office
Facility Name CONVENIENTMD PRIMARY CARE MANCHESTER
Street 545 HOOKSETT RD, UNIT 1
City MANCHESTER
State NH
ZIP 03104
Phone 603 255-4775
CertificateType 4
CertificateEffectiveDate 7/12/2023
CertificateExpirationDate 7/11/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024