47D0991215 CLIA NUMBER - BURLINGTON LAKESIDE CLINIC VA CBOC

Laboratory Demographics

  • CLIA Code: 47D0991215
  • Facility Name: BURLINGTON LAKESIDE CLINIC VA CBOC
  • Facility Address: 128 LAKESIDE AVE
    BURLINGTON, VT
    ZIP 05401
  • Facility Phone: 802 655-1356
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: MARY CLARK
  • NPI Number: 1346636461
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 47D0991215
LAB Type Community Clinic
Facility Name BURLINGTON LAKESIDE CLINIC VA CBOC
Street 128 LAKESIDE AVE
City BURLINGTON
State VT
ZIP 05401
Phone 802 655-1356
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 9/14/2001
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director MARY CLARK

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