47D2239290 CLIA NUMBER - COLCHESTER - T050

Laboratory Demographics

  • CLIA Code: 47D2239290
  • Facility Name: COLCHESTER - T050
  • Facility Address: 125 LAKER LANE
    COLCHESTER, VT
    ZIP 05446
  • Facility Phone: 802 264-5999
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: MORIAH MCCULLAGH
  • NPI Number: 1770183071
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 47D2239290
LAB Type School/Student Health Service
Facility Name COLCHESTER - T050
Street 125 LAKER LANE
City COLCHESTER
State VT
ZIP 05446
Phone 802 264-5999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2025
Certificate Expiration Date 10/10/2027
Facility Type School/Student Health Service
Lab Director MORIAH MCCULLAGH

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