07D2305050 CLIA NUMBER - VILLAGE SQUARE INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 07D2305050
  • Facility Name: VILLAGE SQUARE INTERNAL MEDICINE
  • Facility Address: 8 ELIZABETH STREET
    BETHEL, CT
    ZIP 06801
  • Facility Phone: 203 791-2221
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SEAN P. MCGRADE
  • NPI Number: 1023212032
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 07D2305050
LAB Type Physician Office
Facility Name VILLAGE SQUARE INTERNAL MEDICINE
Street 8 ELIZABETH STREET
City BETHEL
State CT
ZIP 06801
Phone 203 791-2221
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2024
Certificate Expiration Date 5/22/2026
Facility Type Physician Office
Lab Director SEAN P. MCGRADE

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