07D0662274 CLIA NUMBER - BRISTOL CCH GROUP LLC D/B/A COUNTRYSIDE MANOR OF BRISTOL

Laboratory Demographics

  • CLIA Code: 07D0662274
  • Facility Name: BRISTOL CCH GROUP LLC D/B/A COUNTRYSIDE MANOR OF BRISTOL
  • Facility Address: 1660 STAFFORD AVE
    BRISTOL, CT
    ZIP 06010
  • Facility Phone: 860 583-8483
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: GARY MILLER
  • NPI Number: 1073573317
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 07D0662274
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BRISTOL CCH GROUP LLC D/B/A COUNTRYSIDE MANOR OF BRISTOL
Street 1660 STAFFORD AVE
City BRISTOL
State CT
ZIP 06010
Phone 860 583-8483
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director GARY MILLER

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