07D2156611 CLIA NUMBER - HER TRANSFORMATION OBGYN, PLLC

Laboratory Demographics

  • CLIA Code: 07D2156611
  • Facility Name: HER TRANSFORMATION OBGYN, PLLC
  • Facility Address: 2228 BLACK ROCK TPKE, SUITE 211
    FAIRFIELD, CT
    ZIP 06825
  • Facility Phone: (475) 888-0099
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: VALENTINE EDUSA
  • NPI Number: 1104391598
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 07D2156611
LAB Type Physician Office
Facility Name HER TRANSFORMATION OBGYN, PLLC
Street 2228 BLACK ROCK TPKE, SUITE 211
City FAIRFIELD
State CT
ZIP 06825
Phone 4758880099
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type Physician Office
Lab Director VALENTINE EDUSA

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