07D1068726 CLIA NUMBER - ANTHONY ROSELLI, MD PRIME HEALTHCARE, LLC

Laboratory Demographics

  • CLIA Code: 07D1068726
  • Facility Name: ANTHONY ROSELLI, MD PRIME HEALTHCARE, LLC
  • Facility Address: 54 WEST AVON ROAD, SUITE 101
    AVON, CT
    ZIP 06001
  • Facility Phone: 860 674-6146
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANTHONY M. ROSELLI, MD
  • NPI Number: 1518970425
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 07D1068726
LAB Type Physician Office
Facility Name ANTHONY ROSELLI, MD PRIME HEALTHCARE, LLC
Street 54 WEST AVON ROAD, SUITE 101
City AVON
State CT
ZIP 06001
Phone 860 674-6146
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Physician Office
Lab Director ANTHONY M. ROSELLI, MD

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