07D2288590 CLIA NUMBER - MIDDLESEX HEALTH CRESCENT STREET OBGYN

Laboratory Demographics

CLIA Number: 07D2288590

Facility Name: MIDDLESEX HEALTH CRESCENT STREET OBGYN

Facility Address:
250 FLAT ROCK PLACE, 2ND FLOOR
WESTBROOK, CT
ZIP 06498
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Facility Phone Number: 860 358-3360

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1073867818

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	07D2288590
LAB Type	Physician Office
Facility Name	MIDDLESEX HEALTH CRESCENT STREET OBGYN
Street	250 FLAT ROCK PLACE, 2ND FLOOR
City	WESTBROOK
State	CT
ZIP	06498
Phone	860 358-3360
CertificateType	3
CertificateEffectiveDate	8/28/2023
CertificateExpirationDate	8/27/2025
FacilityType	PPMP

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