47D2327256 CLIA NUMBER - MAD RIVER HEALTH, PLLC

Laboratory Demographics

  • CLIA Code: 47D2327256
  • Facility Name: MAD RIVER HEALTH, PLLC
  • Facility Address: 859 OLD COUNTY RD
    WAITSFIELD, VT
    ZIP 05673
  • Facility Phone: 802 595-1430
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN A. WILSON
  • NPI Number: 1821973280
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 47D2327256
LAB Type Physician Office
Facility Name MAD RIVER HEALTH, PLLC
Street 859 OLD COUNTY RD
City WAITSFIELD
State VT
ZIP 05673
Phone 802 595-1430
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2025
Certificate Expiration Date 7/20/2027
Facility Type Physician Office
Lab Director JOHN A. WILSON

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