07D2199508 CLIA NUMBER - MIDSTATE GASTROENTEROLOGY SPECIALISTS

Laboratory Demographics

  • CLIA Code: 07D2199508
  • Facility Name: MIDSTATE GASTROENTEROLOGY SPECIALISTS
  • Facility Address: 455 LEWIS AVE, SUITE 105
    MERIDEN, CT
    ZIP 06451
  • Facility Phone: 203 237-2477
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HOUSEIN WAZAZ
  • NPI Number: 1487677951
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 07D2199508
LAB Type Physician Office
Facility Name MIDSTATE GASTROENTEROLOGY SPECIALISTS
Street 455 LEWIS AVE, SUITE 105
City MERIDEN
State CT
ZIP 06451
Phone 203 237-2477
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Physician Office
Lab Director HOUSEIN WAZAZ

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