47D0090903 CLIA NUMBER - BRATTLEBORO RETREAT

Laboratory Demographics

CLIA Number: 47D0090903

Facility Name: BRATTLEBORO RETREAT

Facility Address:
1 ANNA MARSH LANE
BRATTLEBORO, VT
ZIP 05302
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Facility Phone Number: 802 258-6808

Facility Type: Hospital

Certificate Type: Waiver

NPI Number: 1730185232

Taxonomy: 283Q00000X - Psychiatric Hospital
An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.

CLIA Record

Field Name	Field Value
CLIA Number	47D0090903
LAB Type	Hospital
Facility Name	BRATTLEBORO RETREAT
Street	1 ANNA MARSH LANE
City	BRATTLEBORO
State	VT
ZIP	05302
Phone	802 258-6808
CertificateType	4
CertificateEffectiveDate	3/18/2024
CertificateExpirationDate	3/17/2026
FacilityType	Waiver

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