07D0936018 CLIA NUMBER - BERT COPPOTELLI MD LLC

Laboratory Demographics

  • CLIA Code: 07D0936018
  • Facility Name: BERT COPPOTELLI MD LLC
  • Facility Address: 2 LEE ROAD
    LISBON, CT
    ZIP 06351
  • Facility Phone: 860 376-4451
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BERT COPPOTELLI MD
  • NPI Number: 1629070941
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 07D0936018
LAB Type Physician Office
Facility Name BERT COPPOTELLI MD LLC
Street 2 LEE ROAD
City LISBON
State CT
ZIP 06351
Phone 860 376-4451
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2023
Certificate Expiration Date 11/12/2025
Facility Type Physician Office
Lab Director BERT COPPOTELLI MD

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