07D2180877 CLIA NUMBER - INTERCOMMUNITY

Laboratory Demographics

  • CLIA Code: 07D2180877
  • Facility Name: INTERCOMMUNITY
  • Facility Address: 828 SULLIVAN AVE, SUITE A
    SOUTH WINDSOR, CT
    ZIP 06074
  • Facility Phone: 860 569-5900
  • Facility Type: Other - FQHC-LOOK ALIKE
  • Facility Type: Microscopy
  • Lab Director: CHAD MCDONALD
  • NPI Number: 1497307573
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 07D2180877
LAB Type Other - FQHC-LOOK ALIKE
Facility Name INTERCOMMUNITY
Street 828 SULLIVAN AVE, SUITE A
City SOUTH WINDSOR
State CT
ZIP 06074
Phone 860 569-5900
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 3/23/2024
Certificate Expiration Date 3/22/2026
Facility Type Other - FQHC-LOOK ALIKE
Lab Director CHAD MCDONALD

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