07D2146602 CLIA NUMBER - CT RENAISSANCE, INC

Laboratory Demographics

  • CLIA Code: 07D2146602
  • Facility Name: CT RENAISSANCE, INC
  • Facility Address: 1126 MAIN ST
    BRIDGEPORT, CT
    ZIP 06604
  • Facility Phone: 203 336-5225
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DAWN PATSTON
  • NPI Number: 1215188826
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 07D2146602
LAB Type Community Clinic
Facility Name CT RENAISSANCE, INC
Street 1126 MAIN ST
City BRIDGEPORT
State CT
ZIP 06604
Phone 203 336-5225
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2024
Certificate Expiration Date 4/2/2026
Facility Type Community Clinic
Lab Director DAWN PATSTON

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