47D2302785 CLIA NUMBER - STATE STREET TMS

Laboratory Demographics

  • CLIA Code: 47D2302785
  • Facility Name: STATE STREET TMS
  • Facility Address: 147 STATE ST, STE 101
    MONTPELIER, VT
    ZIP 05602
  • Facility Phone: (802) 419-0500
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: JADA KHOSLA
  • NPI Number: 1588347421
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 47D2302785
LAB Type Independent
Facility Name STATE STREET TMS
Street 147 STATE ST, STE 101
City MONTPELIER
State VT
ZIP 05602
Phone 8024190500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2026
Certificate Expiration Date 4/15/2028
Facility Type Independent
Lab Director JADA KHOSLA

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