07D2169357 CLIA NUMBER - PEDIATRIC, YOUTH AND FAMILY HIV PROGRAM - ROOM 3

Laboratory Demographics

  • CLIA Code: 07D2169357
  • Facility Name: PEDIATRIC, YOUTH AND FAMILY HIV PROGRAM - ROOM 3
  • Facility Address: 385 WASHINGTON ST
    HARTFORD, CT
    ZIP 06106
  • Facility Phone: 860 525-4006
  • Facility Type: Other - PEDIATRIC YOUTH & FAMILY
  • Facility Type: Waiver
  • Lab Director: GREGORY MAKOWSKI
  • NPI Number: 1114970175
  • Taxonomy: 2080P0202X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 07D2169357
LAB Type Other - PEDIATRIC YOUTH & FAMILY
Facility Name PEDIATRIC, YOUTH AND FAMILY HIV PROGRAM - ROOM 3
Street 385 WASHINGTON ST
City HARTFORD
State CT
ZIP 06106
Phone 860 525-4006
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2025
Certificate Expiration Date 7/17/2027
Facility Type Other - PEDIATRIC YOUTH & FAMILY
Lab Director GREGORY MAKOWSKI

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