07D1031984 CLIA NUMBER - DARTMOUTH ENDOCRINOLOGY, DIABETES

Laboratory Demographics

  • CLIA Code: 07D1031984
  • Facility Name: DARTMOUTH ENDOCRINOLOGY, DIABETES
  • Facility Address: 44 DALE ROAD, SUITE 201
    AVON, CT
    ZIP 06001
  • Facility Phone: 860 679-0234
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GREGORY J. BOMBASSEI, MD
  • NPI Number: 1669669982
  • Taxonomy: 207RE0101X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 07D1031984
LAB Type Physician Office
Facility Name DARTMOUTH ENDOCRINOLOGY, DIABETES
Street 44 DALE ROAD, SUITE 201
City AVON
State CT
ZIP 06001
Phone 860 679-0234
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Physician Office
Lab Director GREGORY J. BOMBASSEI, MD

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This page was last updated on: 6/4/2025