07D0928032 CLIA NUMBER - CANDLEWOOD VALLEY PEDIATRICS

Laboratory Demographics

  • CLIA Code: 07D0928032
  • Facility Name: CANDLEWOOD VALLEY PEDIATRICS
  • Facility Address: 120 PARK LANE SUITE A-101
    NEW MILFORD, CT
    ZIP 06776
  • Facility Phone: 860 355-8190
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EVAN R. HACK
  • NPI Number: 1811021066
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 07D0928032
LAB Type Physician Office
Facility Name CANDLEWOOD VALLEY PEDIATRICS
Street 120 PARK LANE SUITE A-101
City NEW MILFORD
State CT
ZIP 06776
Phone 860 355-8190
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2025
Certificate Expiration Date 5/6/2027
Facility Type Physician Office
Lab Director EVAN R. HACK

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