07D0098107 CLIA NUMBER - URGENT CARE MEDICAL ASSOCIATES D/B/A-PHYSICIAN ONE URGENT CARE

Laboratory Demographics

CLIA Number: 07D0098107

Facility Name: URGENT CARE MEDICAL ASSOCIATES D/B/A-PHYSICIAN ONE URGENT CARE

Facility Address:
1040 BARNUM AVENUE
STRATFORD, CT
ZIP 06614
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Facility Phone Number: 860 430-1246

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1336792720

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	07D0098107
LAB Type	Other - URGENT CARE
Facility Name	URGENT CARE MEDICAL ASSOCIATES D/B/A-PHYSICIAN ONE URGENT CARE
Street	1040 BARNUM AVENUE
City	STRATFORD
State	CT
ZIP	06614
Phone	860 430-1246
CertificateType	4
CertificateEffectiveDate	12/9/2023
CertificateExpirationDate	12/8/2025
FacilityType	Waiver

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