07D1078921 CLIA NUMBER - MIDDLESEX HOSPITAL SHORELINE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 07D1078921
  • Facility Name: MIDDLESEX HOSPITAL SHORELINE MEDICAL CENTER
  • Facility Address: 250 FLAT ROCK PLACE
    WESTBROOK, CT
    ZIP 06498
  • Facility Phone: 860 358-3851
  • Facility Type: Tissue Bank/Repositories
  • Facility Type: Waiver
  • Lab Director: JONATHAN D. LEVINE, MD
  • NPI Number: 1073867818
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 07D1078921
LAB Type Tissue Bank/Repositories
Facility Name MIDDLESEX HOSPITAL SHORELINE MEDICAL CENTER
Street 250 FLAT ROCK PLACE
City WESTBROOK
State CT
ZIP 06498
Phone 860 358-3851
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2024
Certificate Expiration Date 1/17/2026
Facility Type Tissue Bank/Repositories
Lab Director JONATHAN D. LEVINE, MD

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