07D2151564 CLIA NUMBER - WALLINGFORD ENDOSCOPY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 07D2151564
  • Facility Name: WALLINGFORD ENDOSCOPY CENTER, LLC
  • Facility Address: 863 NORTH MAIN STREET EXT, SUITE 300
    WALLINGFORD, CT
    ZIP 06492
  • Facility Phone: 860 246-2571
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KEVIN JO
  • NPI Number: 1255820544
  • Taxonomy: 261QE0800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 07D2151564
LAB Type Ambulatory Surgery Center
Facility Name WALLINGFORD ENDOSCOPY CENTER, LLC
Street 863 NORTH MAIN STREET EXT, SUITE 300
City WALLINGFORD
State CT
ZIP 06492
Phone 860 246-2571
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Ambulatory Surgery Center
Lab Director KEVIN JO

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