47D2293285 CLIA NUMBER - CLARA MARTIN CENTER

Laboratory Demographics

  • CLIA Code: 47D2293285
  • Facility Name: CLARA MARTIN CENTER
  • Facility Address: 39 FOGG FARM RD
    WILDER, VT
    ZIP 05088
  • Facility Phone: (802) 728-4466
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KEVIN BUCHANAN
  • NPI Number: 1053679266
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 47D2293285
LAB Type Practitioner Other
Facility Name CLARA MARTIN CENTER
Street 39 FOGG FARM RD
City WILDER
State VT
ZIP 05088
Phone 8027284466
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2025
Certificate Expiration Date 11/6/2027
Facility Type Practitioner Other
Lab Director KEVIN BUCHANAN

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