07D2247988 CLIA NUMBER - HANCOCK PHARMACY V, LLC

Laboratory Demographics

  • CLIA Code: 07D2247988
  • Facility Name: HANCOCK PHARMACY V, LLC
  • Facility Address: 644 MAIN ST
    MIDDLETOWN, CT
    ZIP 06457
  • Facility Phone: 860 346-9700
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUDHEER GHANTA RPH
  • NPI Number: 1457678468
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2247988
LAB Type Pharmacy
Facility Name HANCOCK PHARMACY V, LLC
Street 644 MAIN ST
City MIDDLETOWN
State CT
ZIP 06457
Phone 860 346-9700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type Pharmacy
Lab Director SUDHEER GHANTA RPH

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