07D0966096 CLIA NUMBER - BROADWAY MEDICAL GROUP LLC

Laboratory Demographics

  • CLIA Code: 07D0966096
  • Facility Name: BROADWAY MEDICAL GROUP LLC
  • Facility Address: 2 BROADWAY
    NORTH HAVEN, CT
    ZIP 06473
  • Facility Phone: 203 234-6500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LORENZO S. GALANTE
  • NPI Number: 1649466061
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 07D0966096
LAB Type Physician Office
Facility Name BROADWAY MEDICAL GROUP LLC
Street 2 BROADWAY
City NORTH HAVEN
State CT
ZIP 06473
Phone 203 234-6500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2025
Certificate Expiration Date 10/6/2027
Facility Type Physician Office
Lab Director LORENZO S. GALANTE

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