07D2276954 CLIA NUMBER - CIVIC WILTON

Laboratory Demographics

  • CLIA Code: 07D2276954
  • Facility Name: CIVIC WILTON
  • Facility Address: 249 DANBURY RD
    WILTON, CT
    ZIP 06897
  • Facility Phone: 203 883-0038
  • Facility Type: Other - INFUSION CENTER
  • Facility Type: Waiver
  • Lab Director: LEE ANN PURTTHIPATKOOL APRN
  • NPI Number: 1508375064
  • Taxonomy: 261QI0500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 07D2276954
LAB Type Other - INFUSION CENTER
Facility Name CIVIC WILTON
Street 249 DANBURY RD
City WILTON
State CT
ZIP 06897
Phone 203 883-0038
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Other - INFUSION CENTER
Lab Director LEE ANN PURTTHIPATKOOL APRN

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