07D2280619 CLIA NUMBER - AMPLE URGENT AND PRIMARY CARE

Laboratory Demographics

CLIA Number: 07D2280619

Facility Name: AMPLE URGENT AND PRIMARY CARE

Facility Address:
10 PRINCTON ST
WEST HARTFORD, CT
ZIP 06110
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Facility Phone Number: 860 838-8799

Facility Type: Independent

Certificate Type: Waiver

NPI Number: 1497474191

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	07D2280619
LAB Type	Independent
Facility Name	AMPLE URGENT AND PRIMARY CARE
Street	10 PRINCTON ST
City	WEST HARTFORD
State	CT
ZIP	06110
Phone	860 838-8799
CertificateType	4
CertificateEffectiveDate	4/24/2023
CertificateExpirationDate	4/23/2025
FacilityType	Waiver

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