07D2160472 CLIA NUMBER - GLASTONBURY PEDIATRICS, LLC

Laboratory Demographics

  • CLIA Code: 07D2160472
  • Facility Name: GLASTONBURY PEDIATRICS, LLC
  • Facility Address: 131 NEW LONDON TPKE, SUITE 322
    GLASTONBURY, CT
    ZIP 06033
  • Facility Phone: 860 918-9544
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GUBBANNA V. KUMAR
  • NPI Number: 1679071674
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 07D2160472
LAB Type Physician Office
Facility Name GLASTONBURY PEDIATRICS, LLC
Street 131 NEW LONDON TPKE, SUITE 322
City GLASTONBURY
State CT
ZIP 06033
Phone 860 918-9544
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2025
Certificate Expiration Date 1/10/2027
Facility Type Physician Office
Lab Director GUBBANNA V. KUMAR

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