07D1071201 CLIA NUMBER - STAMFORD HEALTH MEDICAL GROUP, INC

Laboratory Demographics

  • CLIA Code: 07D1071201
  • Facility Name: STAMFORD HEALTH MEDICAL GROUP, INC
  • Facility Address: 29 HOSPITAL PLAZA, SUITE 502
    STAMFORD, CT
    ZIP 06902
  • Facility Phone: 203 348-7410
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EVELYN CUSACK
  • NPI Number: 1922351634
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 07D1071201
LAB Type Physician Office
Facility Name STAMFORD HEALTH MEDICAL GROUP, INC
Street 29 HOSPITAL PLAZA, SUITE 502
City STAMFORD
State CT
ZIP 06902
Phone 203 348-7410
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2025
Certificate Expiration Date 7/19/2027
Facility Type Physician Office
Lab Director EVELYN CUSACK

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