07D2119838 CLIA NUMBER - WHOLE SELF WELLNESS

Laboratory Demographics

  • CLIA Code: 07D2119838
  • Facility Name: WHOLE SELF WELLNESS
  • Facility Address: 627 NORWICH SALEM TURNPIKE, UNIT 2
    OAKDALE, CT
    ZIP 06370
  • Facility Phone: 860 222-0949
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ANDREA S. DAMERON APRN
  • NPI Number: 1588114870
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 07D2119838
LAB Type Practitioner Other
Facility Name WHOLE SELF WELLNESS
Street 627 NORWICH SALEM TURNPIKE, UNIT 2
City OAKDALE
State CT
ZIP 06370
Phone 860 222-0949
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2024
Certificate Expiration Date 10/4/2026
Facility Type Practitioner Other
Lab Director ANDREA S. DAMERON APRN

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