07D0713717 CLIA NUMBER - MIDDLESEX HEALTH PRIMARY CARE - SHORELINE

Laboratory Demographics

  • CLIA Code: 07D0713717
  • Facility Name: MIDDLESEX HEALTH PRIMARY CARE - SHORELINE
  • Facility Address: 1353 BOSTON POST ROAD
    MADISON, CT
    ZIP 06443
  • Facility Phone: 203 245-4933
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNIFER P. SWENSON, MD
  • NPI Number: 1093138935
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 07D0713717
LAB Type Physician Office
Facility Name MIDDLESEX HEALTH PRIMARY CARE - SHORELINE
Street 1353 BOSTON POST ROAD
City MADISON
State CT
ZIP 06443
Phone 203 245-4933
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2025
Certificate Expiration Date 12/31/2026
Facility Type Physician Office
Lab Director JENNIFER P. SWENSON, MD

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