07D1092929 CLIA NUMBER - VILLAGE PEDIATRICS LLC

Laboratory Demographics

  • CLIA Code: 07D1092929
  • Facility Name: VILLAGE PEDIATRICS LLC
  • Facility Address: 323 RIVERSIDE AVE
    WESTPORT, CT
    ZIP 06880
  • Facility Phone: 203 221-7337
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NICOLE C. GORMAN
  • NPI Number: 1487809901
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 07D1092929
LAB Type Physician Office
Facility Name VILLAGE PEDIATRICS LLC
Street 323 RIVERSIDE AVE
City WESTPORT
State CT
ZIP 06880
Phone 203 221-7337
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2024
Certificate Expiration Date 12/7/2026
Facility Type Physician Office
Lab Director NICOLE C. GORMAN

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