47D0091310 CLIA NUMBER - GREEN MOUNTAIN NURSING HOME

Laboratory Demographics

  • CLIA Code: 47D0091310
  • Facility Name: GREEN MOUNTAIN NURSING HOME
  • Facility Address: 475 ETHAN ALLEN AVE
    COLCHESTER, VT
    ZIP 05446
  • Facility Phone: 802 655-1025
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JENNIFER COMBS-WILBER
  • NPI Number: 1629457908
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 47D0091310
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GREEN MOUNTAIN NURSING HOME
Street 475 ETHAN ALLEN AVE
City COLCHESTER
State VT
ZIP 05446
Phone 802 655-1025
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JENNIFER COMBS-WILBER

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