07D2311577 CLIA NUMBER - CONNECTICUT JUNIOR REPUBLIC ASSOCIATION

Laboratory Demographics

  • CLIA Code: 07D2311577
  • Facility Name: CONNECTICUT JUNIOR REPUBLIC ASSOCIATION
  • Facility Address: 550 GOSHEN ROAD
    LITCHFIELD, CT
    ZIP 06759
  • Facility Phone: 860 567-9423
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: DANIEL W. REZENDE
  • NPI Number: 1174644926
  • Taxonomy: 261QM0855X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 07D2311577
LAB Type School/Student Health Service
Facility Name CONNECTICUT JUNIOR REPUBLIC ASSOCIATION
Street 550 GOSHEN ROAD
City LITCHFIELD
State CT
ZIP 06759
Phone 860 567-9423
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type School/Student Health Service
Lab Director DANIEL W. REZENDE

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