07D2078710 CLIA NUMBER - IVELISSE VIRUET

Laboratory Demographics

  • CLIA Code: 07D2078710
  • Facility Name: IVELISSE VIRUET
  • Facility Address: 153 MAIN ST STE 8
    MANCHESTER, CT
    ZIP 06042
  • Facility Phone: 860 432-5803
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IVELISSE VIRUET MD
  • NPI Number: 1629055249
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 07D2078710
LAB Type Physician Office
Facility Name IVELISSE VIRUET
Street 153 MAIN ST STE 8
City MANCHESTER
State CT
ZIP 06042
Phone 860 432-5803
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Physician Office
Lab Director IVELISSE VIRUET MD

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