07D0954296 CLIA NUMBER - SHANTHI DEVARAJ MD LLC

Laboratory Demographics

  • CLIA Code: 07D0954296
  • Facility Name: SHANTHI DEVARAJ MD LLC
  • Facility Address: 1400 BEDFORD STREET
    STAMFORD, CT
    ZIP 06905
  • Facility Phone: 203 323-8700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHANTHI DEVARAJ MD
  • NPI Number: 1063565844
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 07D0954296
LAB Type Physician Office
Facility Name SHANTHI DEVARAJ MD LLC
Street 1400 BEDFORD STREET
City STAMFORD
State CT
ZIP 06905
Phone 203 323-8700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/23/2024
Certificate Expiration Date 11/22/2026
Facility Type Physician Office
Lab Director SHANTHI DEVARAJ MD

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