07D2082035 CLIA NUMBER - HHC SOUTHINGTON SURGERY CENTER DBA-CHESHIRE SURGERY CENTER

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Laboratory Demographics

CLIA Number: 07D2082035

Facility Name: HHC SOUTHINGTON SURGERY CENTER DBA-CHESHIRE SURGERY CENTER

Facility Address:
765 WEST JOHNSON AVE
CHESHIRE, CT
ZIP 06410
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Facility Phone Number: 860 438-8044

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1528479664

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	07D2082035
LAB Type	Ambulatory Surgery Center
Facility Name	HHC SOUTHINGTON SURGERY CENTER DBA-CHESHIRE SURGERY CENTER
Street	765 WEST JOHNSON AVE
City	CHESHIRE
State	CT
ZIP	06410
Phone	860 438-8044
CertificateType	4
CertificateEffectiveDate	8/6/2022
CertificateExpirationDate	8/5/2024
FacilityType	Waiver

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