07D0880583 CLIA NUMBER - CROMWELL OPERATIONS, LLC DBA AUTUMN LAKE HEALTH CARE AT CROMWELL

Laboratory Demographics

  • CLIA Code: 07D0880583
  • Facility Name: CROMWELL OPERATIONS, LLC DBA AUTUMN LAKE HEALTH CARE AT CROMWELL
  • Facility Address: 385 MAIN ST
    CROMWELL, CT
    ZIP 06416
  • Facility Phone: 860 635-5613
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MARC P. RAAD
  • NPI Number: 1912301995
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 07D0880583
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CROMWELL OPERATIONS, LLC DBA AUTUMN LAKE HEALTH CARE AT CROMWELL
Street 385 MAIN ST
City CROMWELL
State CT
ZIP 06416
Phone 860 635-5613
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2023
Certificate Expiration Date 12/15/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MARC P. RAAD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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