07D0883574 CLIA NUMBER - CONNECTICUT COASTAL OB/GYN, PC

Laboratory Demographics

  • CLIA Code: 07D0883574
  • Facility Name: CONNECTICUT COASTAL OB/GYN, PC
  • Facility Address: 420 E MAIN ST
    BRANFORD, CT
    ZIP 06405
  • Facility Phone: 203 481-7018
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RAYME SHORE
  • NPI Number: 1932324993
  • Taxonomy: 261QM1200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 07D0883574
LAB Type Physician Office
Facility Name CONNECTICUT COASTAL OB/GYN, PC
Street 420 E MAIN ST
City BRANFORD
State CT
ZIP 06405
Phone 203 481-7018
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 3/11/2024
Certificate Expiration Date 3/10/2026
Facility Type Physician Office
Lab Director RAYME SHORE

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