47D0091477 CLIA NUMBER - FIDDLEHEAD LEDGE LLC

Laboratory Demographics

  • CLIA Code: 47D0091477
  • Facility Name: FIDDLEHEAD LEDGE LLC
  • Facility Address: 12 CHURCH ST, STE 1
    SWANTON, VT
    ZIP 05488
  • Facility Phone: 802 868-3175
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KRISTINA UNIKEWICZ
  • NPI Number: 1669146510
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 47D0091477
LAB Type Physician Office
Facility Name FIDDLEHEAD LEDGE LLC
Street 12 CHURCH ST, STE 1
City SWANTON
State VT
ZIP 05488
Phone 802 868-3175
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 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director KRISTINA UNIKEWICZ

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