07D1087350 CLIA NUMBER - FAIRFIELD COUNTY INTEGRATIVE FAMILY MEDICINE, LLC

Laboratory Demographics

CLIA Number: 07D1087350

Facility Name: FAIRFIELD COUNTY INTEGRATIVE FAMILY MEDICINE, LLC

Facility Address:
324 ELM ST, SUITE 203A
MONROE, CT
ZIP 06468
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Facility Phone Number: 203 445-9060

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1629239751

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	07D1087350
LAB Type	Physician Office
Facility Name	FAIRFIELD COUNTY INTEGRATIVE FAMILY MEDICINE, LLC
Street	324 ELM ST, SUITE 203A
City	MONROE
State	CT
ZIP	06468
Phone	203 445-9060
CertificateType	3
CertificateEffectiveDate	8/1/2022
CertificateExpirationDate	7/31/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024