07D0868089 CLIA NUMBER - BROOKSIDE GYNECOLOGY ASSOCIATES PC

Laboratory Demographics

  • CLIA Code: 07D0868089
  • Facility Name: BROOKSIDE GYNECOLOGY ASSOCIATES PC
  • Facility Address: 159 WEST PUTNAM AVE
    GREENWICH, CT
    ZIP 06830
  • Facility Phone: 203 869-7080
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: FRANCIS GAETANE
  • NPI Number: 1578588877
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 07D0868089
LAB Type Physician Office
Facility Name BROOKSIDE GYNECOLOGY ASSOCIATES PC
Street 159 WEST PUTNAM AVE
City GREENWICH
State CT
ZIP 06830
Phone 203 869-7080
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director FRANCIS GAETANE

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