07D2111489 CLIA NUMBER - WELLMORE

Laboratory Demographics

  • CLIA Code: 07D2111489
  • Facility Name: WELLMORE
  • Facility Address: 402 E MAIN ST
    WATERBURY, CT
    ZIP 06702
  • Facility Phone: 203 574-9000
  • Facility Type: Other - BEHAVIORAL HLTH AGENCY
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER YOUNG
  • NPI Number: 1962760561
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 07D2111489
LAB Type Other - BEHAVIORAL HLTH AGENCY
Facility Name WELLMORE
Street 402 E MAIN ST
City WATERBURY
State CT
ZIP 06702
Phone 203 574-9000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2024
Certificate Expiration Date 4/6/2026
Facility Type Other - BEHAVIORAL HLTH AGENCY
Lab Director CHRISTOPHER YOUNG

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