07D0099958 CLIA NUMBER - CONNECTICUT KIDNEY & HYPERTENSION SPECIALIST, LLC

Laboratory Demographics

  • CLIA Code: 07D0099958
  • Facility Name: CONNECTICUT KIDNEY & HYPERTENSION SPECIALIST, LLC
  • Facility Address: 140 GRANDVIEW AVENUE, SUITE 101
    WATERBURY, CT
    ZIP 06708
  • Facility Phone: 203 597-9733
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANTHONY J. CUSANO
  • NPI Number: 1962651968
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 07D0099958
LAB Type Physician Office
Facility Name CONNECTICUT KIDNEY & HYPERTENSION SPECIALIST, LLC
Street 140 GRANDVIEW AVENUE, SUITE 101
City WATERBURY
State CT
ZIP 06708
Phone 203 597-9733
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2023
Certificate Expiration Date 8/30/2025
Facility Type Physician Office
Lab Director ANTHONY J. CUSANO

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This page was last updated on: 3/20/2025