07D0095182 CLIA NUMBER - MANSFIELD FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 07D0095182
  • Facility Name: MANSFIELD FAMILY PRACTICE LLC
  • Facility Address: 34 PROFESSIONAL PARK ROAD
    STORRS, CT
    ZIP 06268
  • Facility Phone: (860) 487-0002
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AYAZ T. MADRASWALLA
  • NPI Number: 1265546956
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 07D0095182
LAB Type Physician Office
Facility Name MANSFIELD FAMILY PRACTICE LLC
Street 34 PROFESSIONAL PARK ROAD
City STORRS
State CT
ZIP 06268
Phone 8604870002
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2024
Certificate Expiration Date 7/31/2026
Facility Type Physician Office
Lab Director AYAZ T. MADRASWALLA

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This page was last updated on: 5/15/2026