47D0090643 CLIA NUMBER - MT ASCUTNEY HOSPITAL OTTAUQUECHEE HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 47D0090643
  • Facility Name: MT ASCUTNEY HOSPITAL OTTAUQUECHEE HEALTH CENTER
  • Facility Address: 32 PLEASANT ST
    WOODSTOCK, VT
    ZIP 05091
  • Facility Phone: 802 457-3030
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CLARE N. DREBITKO
  • NPI Number: 1407447014
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 47D0090643
LAB Type Physician Office
Facility Name MT ASCUTNEY HOSPITAL OTTAUQUECHEE HEALTH CENTER
Street 32 PLEASANT ST
City WOODSTOCK
State VT
ZIP 05091
Phone 802 457-3030
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/5/2025
Certificate Expiration Date 3/4/2027
Facility Type Physician Office
Lab Director CLARE N. DREBITKO

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