07D2042246 CLIA NUMBER - EAST AVENUE PEDIATRICS, PC

Laboratory Demographics

  • CLIA Code: 07D2042246
  • Facility Name: EAST AVENUE PEDIATRICS, PC
  • Facility Address: 148 EAST AVENUE SUITE 1 L
    NORWALK, CT
    ZIP 06851
  • Facility Phone: 203 854-6993
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. LIBIA RUEDA-MATIK
  • NPI Number: 1093092165
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 07D2042246
LAB Type Physician Office
Facility Name EAST AVENUE PEDIATRICS, PC
Street 148 EAST AVENUE SUITE 1 L
City NORWALK
State CT
ZIP 06851
Phone 203 854-6993
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2024
Certificate Expiration Date 6/6/2026
Facility Type Physician Office
Lab Director DR. LIBIA RUEDA-MATIK

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