07D2169557 CLIA NUMBER - WATERBURY HOSPITAL MIDDLEBURY BLOOD COLLECTION FACILITY

Laboratory Demographics

CLIA Number: 07D2169557

Facility Name: WATERBURY HOSPITAL MIDDLEBURY BLOOD COLLECTION FACILITY

Facility Address:
1625 STRAITS TPKE, SUITE 304
MIDDLEBURY, CT
ZIP 06762
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Facility Phone Number: 203 577-2299

Facility Type: Other - BCF

Certificate Type: Waiver

NPI Number: 1255378501

Taxonomy: 2084N0400X - Psychiatry & Neurology
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

CLIA Record

Field Name	Field Value
CLIA Number	07D2169557
LAB Type	Other - BCF
Facility Name	WATERBURY HOSPITAL MIDDLEBURY BLOOD COLLECTION FACILITY
Street	1625 STRAITS TPKE, SUITE 304
City	MIDDLEBURY
State	CT
ZIP	06762
Phone	203 577-2299
CertificateType	4
CertificateEffectiveDate	7/23/2023
CertificateExpirationDate	7/22/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024