07D2114176 CLIA NUMBER - OLD MYSTIC FIRE DEPARTMENT

Laboratory Demographics

  • CLIA Code: 07D2114176
  • Facility Name: OLD MYSTIC FIRE DEPARTMENT
  • Facility Address: 295 COW HILL RD
    MYSTIC, CT
    ZIP 06355
  • Facility Phone: 860 536-3432
  • Facility Type: Other - FIRE DEPT
  • Facility Type: Waiver
  • Lab Director: KENNETH W. RICHARDS JR
  • NPI Number: 1073981536
  • Taxonomy: 146N00000X - Emergency Medical Technician, Basic

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CLIA Record

Field Name Field Value
CLIA Number 07D2114176
LAB Type Other - FIRE DEPT
Facility Name OLD MYSTIC FIRE DEPARTMENT
Street 295 COW HILL RD
City MYSTIC
State CT
ZIP 06355
Phone 860 536-3432
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2024
Certificate Expiration Date 6/7/2026
Facility Type Other - FIRE DEPT
Lab Director KENNETH W. RICHARDS JR

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