07D2315865 CLIA NUMBER - SILVER BIRCH MD LLC

Laboratory Demographics

  • CLIA Code: 07D2315865
  • Facility Name: SILVER BIRCH MD LLC
  • Facility Address: 15 PALOMBA DRIVE SUITE 5
    ENFIELD, CT
    ZIP 06082
  • Facility Phone: 860 745-0030
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IAN S. TUCKER
  • NPI Number: 1861208217
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 07D2315865
LAB Type Physician Office
Facility Name SILVER BIRCH MD LLC
Street 15 PALOMBA DRIVE SUITE 5
City ENFIELD
State CT
ZIP 06082
Phone 860 745-0030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Physician Office
Lab Director IAN S. TUCKER

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