07D2262336 CLIA NUMBER - CONNECTICUT GI, PC

Laboratory Demographics

CLIA Number: 07D2262336

Facility Name: CONNECTICUT GI, PC

Facility Address:
55 MERIDEN AVE, 2C
SOUTHINGTON, CT
ZIP 06489
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Facility Phone Number: 860 621-6284

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1972586675

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	07D2262336
LAB Type	Physician Office
Facility Name	CONNECTICUT GI, PC
Street	55 MERIDEN AVE, 2C
City	SOUTHINGTON
State	CT
ZIP	06489
Phone	860 621-6284
CertificateType	4
CertificateEffectiveDate	6/13/2022
CertificateExpirationDate	6/12/2024
FacilityType	Waiver

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