07D2141644 CLIA NUMBER - BRISTOL HOSPITAL EMS, LLC

Laboratory Demographics

  • CLIA Code: 07D2141644
  • Facility Name: BRISTOL HOSPITAL EMS, LLC
  • Facility Address: 371 TERRYVILLE AVE
    BRISTOL, CT
    ZIP 06010
  • Facility Phone: (860) 585-3679
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: DAVID B. KOSCUK
  • NPI Number: 1184615684
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 07D2141644
LAB Type Ambulance
Facility Name BRISTOL HOSPITAL EMS, LLC
Street 371 TERRYVILLE AVE
City BRISTOL
State CT
ZIP 06010
Phone 8605853679
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2025
Certificate Expiration Date 12/18/2027
Facility Type Ambulance
Lab Director DAVID B. KOSCUK

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This page was last updated on: 5/18/2026