07D0096311 CLIA NUMBER - MHS PRIMARY CARE INC

Laboratory Demographics

  • CLIA Code: 07D0096311
  • Facility Name: MHS PRIMARY CARE INC
  • Facility Address: 27 WILLIAM F PALMER RD
    MOODUS, CT
    ZIP 06469
  • Facility Phone: 860 358-5220
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MALCOLM P. GOURLIE
  • NPI Number: 1811322951
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 07D0096311
LAB Type Physician Office
Facility Name MHS PRIMARY CARE INC
Street 27 WILLIAM F PALMER RD
City MOODUS
State CT
ZIP 06469
Phone 860 358-5220
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director MALCOLM P. GOURLIE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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