07D0950376 CLIA NUMBER - MHS PRIMARY CARE WESTBROOK

Laboratory Demographics

  • CLIA Code: 07D0950376
  • Facility Name: MHS PRIMARY CARE WESTBROOK
  • Facility Address: 250 FLAT ROCK PL
    WESTBROOK, CT
    ZIP 06498
  • Facility Phone: (860) 664-3553
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHANE T. RIDGE
  • NPI Number: 1356717482
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 07D0950376
LAB Type Physician Office
Facility Name MHS PRIMARY CARE WESTBROOK
Street 250 FLAT ROCK PL
City WESTBROOK
State CT
ZIP 06498
Phone 8606643553
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2024
Certificate Expiration Date 8/24/2026
Facility Type Physician Office
Lab Director SHANE T. RIDGE

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This page was last updated on: 5/18/2026