07D2119140 CLIA NUMBER - CONNECTICUT CHILDRENS PRIMARY CARE CENTER

Laboratory Demographics

  • CLIA Code: 07D2119140
  • Facility Name: CONNECTICUT CHILDRENS PRIMARY CARE CENTER
  • Facility Address: 800 CONNECTICUT BLVD
    EAST HARTFORD, CT
    ZIP 06108
  • Facility Phone: 860 545-8124
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GREGORY MAKOWSKI
  • NPI Number: 1710954961
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 07D2119140
LAB Type Physician Office
Facility Name CONNECTICUT CHILDRENS PRIMARY CARE CENTER
Street 800 CONNECTICUT BLVD
City EAST HARTFORD
State CT
ZIP 06108
Phone 860 545-8124
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Physician Office
Lab Director GREGORY MAKOWSKI

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