47D0091375 CLIA NUMBER - CHAMPLAIN OBGYN

Laboratory Demographics

  • CLIA Code: 47D0091375
  • Facility Name: CHAMPLAIN OBGYN
  • Facility Address: 55 MAIN ST, STE 3
    ESSEX JUNCTION, VT
    ZIP 05452
  • Facility Phone: 802 879-1802
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARIA G. CARRACINO
  • NPI Number: 1871940064
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 47D0091375
LAB Type Physician Office
Facility Name CHAMPLAIN OBGYN
Street 55 MAIN ST, STE 3
City ESSEX JUNCTION
State VT
ZIP 05452
Phone 802 879-1802
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 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Physician Office
Lab Director MARIA G. CARRACINO

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