07D2234522 CLIA NUMBER - JOSCO MEDICAL GROUP, LLC

Laboratory Demographics

CLIA Number: 07D2234522

Facility Name: JOSCO MEDICAL GROUP, LLC

Facility Address:
12 NORTH MAIN ST, STE 110
WEST HARTFORD, CT
ZIP 06107
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Facility Phone Number: 860 337-9800

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1396314266

Taxonomy: 363L00000X - Nurse Practitioner
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

CLIA Record

Field Name	Field Value
CLIA Number	07D2234522
LAB Type	Practitioner Other
Facility Name	JOSCO MEDICAL GROUP, LLC
Street	12 NORTH MAIN ST, STE 110
City	WEST HARTFORD
State	CT
ZIP	06107
Phone	860 337-9800
CertificateType	4
CertificateEffectiveDate	9/1/2023
CertificateExpirationDate	8/31/2025
FacilityType	Waiver

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