07D2197824 CLIA NUMBER - WATERMARK AT HOME ASSISTED LIVING FACILITY

Laboratory Demographics

  • CLIA Code: 07D2197824
  • Facility Name: WATERMARK AT HOME ASSISTED LIVING FACILITY
  • Facility Address: 3030 PARK AVE
    BRIDGEPORT, CT
    ZIP 06604
  • Facility Phone: 203 373-6113
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: RAHUL GUPTA
  • NPI Number: 1275704462
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 07D2197824
LAB Type Assisted Living Facility
Facility Name WATERMARK AT HOME ASSISTED LIVING FACILITY
Street 3030 PARK AVE
City BRIDGEPORT
State CT
ZIP 06604
Phone 203 373-6113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Assisted Living Facility
Lab Director RAHUL GUPTA

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