07D2113910 CLIA NUMBER - AETNA AMBULANCE SERVICE, INC

Laboratory Demographics

CLIA Number: 07D2113910

Facility Name: AETNA AMBULANCE SERVICE, INC

Facility Address:
140 VAN BLOCK AVE
HARTFORD, CT
ZIP 06114
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Facility Phone Number: 860 647-9798

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1194842781

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	07D2113910
LAB Type	Ambulance
Facility Name	AETNA AMBULANCE SERVICE, INC
Street	140 VAN BLOCK AVE
City	HARTFORD
State	CT
ZIP	06114
Phone	860 647-9798
CertificateType	4
CertificateEffectiveDate	6/2/2022
CertificateExpirationDate	6/1/2024
FacilityType	Waiver

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