07D2276949 CLIA NUMBER - CIVIC FARMINGTON

Laboratory Demographics

CLIA Number: 07D2276949

Facility Name: CIVIC FARMINGTON

Facility Address:
220 FARMINGTON AVE, STE 2
FARMINGTON, CT
ZIP 06032
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Facility Phone Number: 203 883-0038

Facility Type: Other - INFUSION CENTER

Certificate Type: Waiver

NPI Number: 1760138366

Taxonomy: 261QI0500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	07D2276949
LAB Type	Other - INFUSION CENTER
Facility Name	CIVIC FARMINGTON
Street	220 FARMINGTON AVE, STE 2
City	FARMINGTON
State	CT
ZIP	06032
Phone	203 883-0038
CertificateType	4
CertificateEffectiveDate	2/17/2023
CertificateExpirationDate	2/16/2025
FacilityType	Waiver

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