47D2161166 CLIA NUMBER - GREEN MOUNTAIN PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 47D2161166
  • Facility Name: GREEN MOUNTAIN PRIMARY CARE
  • Facility Address: 102A COURT ST
    MIDDLEBURY, VT
    ZIP 05753
  • Facility Phone: 802 382-0849
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAURA WEYLMAN
  • NPI Number: 1265901938
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 47D2161166
LAB Type Physician Office
Facility Name GREEN MOUNTAIN PRIMARY CARE
Street 102A COURT ST
City MIDDLEBURY
State VT
ZIP 05753
Phone 802 382-0849
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/29/2025
Certificate Expiration Date 1/28/2027
Facility Type Physician Office
Lab Director LAURA WEYLMAN

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