07D2035359 CLIA NUMBER - INTERCOMMUNITY INC

Laboratory Demographics

  • CLIA Code: 07D2035359
  • Facility Name: INTERCOMMUNITY INC
  • Facility Address: 40 COVENTRY ST
    HARTFORD, CT
    ZIP 06112
  • Facility Phone: 860 569-5900
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: CHAD MCDONALD
  • NPI Number: 1164580379
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 07D2035359
LAB Type Federally Qualified Health Center
Facility Name INTERCOMMUNITY INC
Street 40 COVENTRY ST
City HARTFORD
State CT
ZIP 06112
Phone 860 569-5900
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/2/2025
Certificate Expiration Date 8/1/2027
Facility Type Federally Qualified Health Center
Lab Director CHAD MCDONALD

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