07D0715861 CLIA NUMBER - STAMFORD PRIMARY CARE ATTN-MARY VOTA

Laboratory Demographics

  • CLIA Code: 07D0715861
  • Facility Name: STAMFORD PRIMARY CARE ATTN-MARY VOTA
  • Facility Address: 1275 SUMMER STREET SUITE 105
    STAMFORD, CT
    ZIP 06905
  • Facility Phone: 203 325-2667
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES BIVONA MD
  • NPI Number: 1730393307
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 07D0715861
LAB Type Physician Office
Facility Name STAMFORD PRIMARY CARE ATTN-MARY VOTA
Street 1275 SUMMER STREET SUITE 105
City STAMFORD
State CT
ZIP 06905
Phone 203 325-2667
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 Physician Office
Lab Director JAMES BIVONA MD

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