07D2195598 CLIA NUMBER - DARIEN CENTER FOR COMPREHENSIVE DENTISTRY LLC

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Laboratory Demographics

CLIA Number: 07D2195598

Facility Name: DARIEN CENTER FOR COMPREHENSIVE DENTISTRY LLC

Facility Address:
36 OLD KINGS HWY SO
DARIEN, CT
ZIP 06820
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Facility Phone Number: 203 655-0667

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1295039063

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	07D2195598
LAB Type	Practitioner Other
Facility Name	DARIEN CENTER FOR COMPREHENSIVE DENTISTRY LLC
Street	36 OLD KINGS HWY SO
City	DARIEN
State	CT
ZIP	06820
Phone	203 655-0667
CertificateType	4
CertificateEffectiveDate	10/9/2022
CertificateExpirationDate	10/8/2024
FacilityType	Waiver

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