07D0862553 CLIA NUMBER - PROHEALTH PHYSICIANS PEDIATRIC & ADOLESCENT MEDICNE

Laboratory Demographics

  • CLIA Code: 07D0862553
  • Facility Name: PROHEALTH PHYSICIANS PEDIATRIC & ADOLESCENT MEDICNE
  • Facility Address: 1062 BARNES RD, SUITE 102
    WALLINGFORD, CT
    ZIP 06492
  • Facility Phone: 203 294-6328
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KERLINE VASSEL-KLAUS
  • NPI Number: 1871770230
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 07D0862553
LAB Type Physician Office
Facility Name PROHEALTH PHYSICIANS PEDIATRIC & ADOLESCENT MEDICNE
Street 1062 BARNES RD, SUITE 102
City WALLINGFORD
State CT
ZIP 06492
Phone 203 294-6328
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2025
Certificate Expiration Date 8/6/2027
Facility Type Physician Office
Lab Director KERLINE VASSEL-KLAUS

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