47D0902414 CLIA NUMBER - ANGELA WINGATE MD

Laboratory Demographics

  • CLIA Code: 47D0902414
  • Facility Name: ANGELA WINGATE MD
  • Facility Address: 160 BENMONT AVENUE SUITE 25
    BENNINGTON, VT
    ZIP 05201
  • Facility Phone: 802 442-0158
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANGELA WINGATE
  • NPI Number: 1811997273
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 47D0902414
LAB Type Physician Office
Facility Name ANGELA WINGATE MD
Street 160 BENMONT AVENUE SUITE 25
City BENNINGTON
State VT
ZIP 05201
Phone 802 442-0158
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 6/20/2025
Certificate Expiration Date 6/19/2027
Facility Type Physician Office
Lab Director ANGELA WINGATE

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