Healthcare Provider Details

I. General information

NPI: 1467373761
Provider Name (Legal Business Name): INFINITE DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LIBERTY SQ STE 3
NEW BRITAIN CT
06051-2637
US

IV. Provider business mailing address

1 LIBERTY SQ STE 3
NEW BRITAIN CT
06051-2637
US

V. Phone/Fax

Practice location:
  • Phone: 860-351-1625
  • Fax:
Mailing address:
  • Phone: 860-351-1625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: TYIESHA PETTUS
Title or Position: PHLEBOTOMIST
Credential: EMPLOYEE
Phone: 860-351-1625