07D2129177 CLIA NUMBER - MATRIX PERSONALIZED MEDICINE, LLC

Laboratory Demographics

  • CLIA Code: 07D2129177
  • Facility Name: MATRIX PERSONALIZED MEDICINE, LLC
  • Facility Address: 45 GROVE ST
    NEW CANAAN, CT
    ZIP 06840
  • Facility Phone: 203 493-6633
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LARRY LEIBOWITZ
  • NPI Number: 1194454603
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 07D2129177
LAB Type Physician Office
Facility Name MATRIX PERSONALIZED MEDICINE, LLC
Street 45 GROVE ST
City NEW CANAAN
State CT
ZIP 06840
Phone 203 493-6633
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Physician Office
Lab Director LARRY LEIBOWITZ

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