07D2201972 CLIA NUMBER - BROTANEK & BERCHELMANN PEDIATRICS

Laboratory Demographics

  • CLIA Code: 07D2201972
  • Facility Name: BROTANEK & BERCHELMANN PEDIATRICS
  • Facility Address: 1180 NEWFIELD AVE
    STAMFORD, CT
    ZIP 06905
  • Facility Phone: 314 888-5233
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: KATHLEEN M. BERCHELMANN
  • NPI Number: 1396201307
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 07D2201972
LAB Type Mobile Laboratory
Facility Name BROTANEK & BERCHELMANN PEDIATRICS
Street 1180 NEWFIELD AVE
City STAMFORD
State CT
ZIP 06905
Phone 314 888-5233
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2024
Certificate Expiration Date 11/23/2026
Facility Type Mobile Laboratory
Lab Director KATHLEEN M. BERCHELMANN

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