07D0097894 CLIA NUMBER - SOUTHPORT CENTER FOR NURSING AND REHABILITATION

Laboratory Demographics

  • CLIA Code: 07D0097894
  • Facility Name: SOUTHPORT CENTER FOR NURSING AND REHABILITATION
  • Facility Address: 930 MILL HILL TER
    SOUTHPORT, CT
    ZIP 06890
  • Facility Phone: 203 259-7894
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. GEORGE GOLDFARB
  • NPI Number: 1386210755
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 07D0097894
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SOUTHPORT CENTER FOR NURSING AND REHABILITATION
Street 930 MILL HILL TER
City SOUTHPORT
State CT
ZIP 06890
Phone 203 259-7894
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2023
Certificate Expiration Date 9/17/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. GEORGE GOLDFARB

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This page was last updated on: 6/4/2025