47D0979284 CLIA NUMBER - MAPLEWOOD FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 47D0979284
  • Facility Name: MAPLEWOOD FAMILY PRACTICE
  • Facility Address: 63 BELMONT AVE
    BRATTLEBORO, VT
    ZIP 05301
  • Facility Phone: (802) 254-1311
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: TONY BLOFSON
  • NPI Number: 1437281045
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 47D0979284
LAB Type Physician Office
Facility Name MAPLEWOOD FAMILY PRACTICE
Street 63 BELMONT AVE
City BRATTLEBORO
State VT
ZIP 05301
Phone 8022541311
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 10/18/2024
Certificate Expiration Date 10/17/2026
Facility Type Physician Office
Lab Director TONY BLOFSON

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This page was last updated on: 5/18/2026