07D2154921 CLIA NUMBER - BRIDGEPORT PHARMACY, LLC

Laboratory Demographics

  • CLIA Code: 07D2154921
  • Facility Name: BRIDGEPORT PHARMACY, LLC
  • Facility Address: 978 E MAIN ST
    BRIDGEPORT, CT
    ZIP 06608
  • Facility Phone: 203 367-9000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAKSHMANA M. PUDIPEDDI
  • NPI Number: 1588821789
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2154921
LAB Type Pharmacy
Facility Name BRIDGEPORT PHARMACY, LLC
Street 978 E MAIN ST
City BRIDGEPORT
State CT
ZIP 06608
Phone 203 367-9000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Pharmacy
Lab Director LAKSHMANA M. PUDIPEDDI

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