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07D0093454 CLIA NUMBER - ELLINGTON PEDIATRICS/F PALAZZOLO MD

Laboratory Demographics

CLIA Number: 07D0093454

Facility Name: ELLINGTON PEDIATRICS/F PALAZZOLO MD

Facility Address:
38 WEST RD
ELLINGTON, CT
ZIP 06029
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Facility Phone Number: 860 870-8841

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1932611852

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

CLIA Record

Field Name Field Value
CLIA Number 07D0093454
LAB Type Physician Office
Facility Name ELLINGTON PEDIATRICS/F PALAZZOLO MD
Street 38 WEST RD
City ELLINGTON
State CT
ZIP 06029
Phone 860 870-8841
CertificateType 4
CertificateEffectiveDate 6/21/2022
CertificateExpirationDate 6/20/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024