07D2305535 CLIA NUMBER - STAMFORD HEALTH MEDICAL GROUP, INC

Laboratory Demographics

  • CLIA Code: 07D2305535
  • Facility Name: STAMFORD HEALTH MEDICAL GROUP, INC
  • Facility Address: 170 WASHINGTON BLVD
    STAMFORD, CT
    ZIP 06902
  • Facility Phone: 203 276-2472
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROMULO VASQUEZ
  • NPI Number: 1588618540
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 07D2305535
LAB Type Physician Office
Facility Name STAMFORD HEALTH MEDICAL GROUP, INC
Street 170 WASHINGTON BLVD
City STAMFORD
State CT
ZIP 06902
Phone 203 276-2472
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Physician Office
Lab Director ROMULO VASQUEZ

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