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General NPI Number Information
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NPI Number | 1780797936
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Entity Type | Organization
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Legal Business Name | CONNECTICUT PATHOLOGY LABORATORIES, INC.
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 1320 MAIN ST STE. 24
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City | WILLIMANTIC
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State | CT
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Zip | 06226-1940
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Country | US
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Telephone | 862-803-1079
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Fax |
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Provider Business Mailing Address
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Address Line | 1320 MAIN ST STE. 24
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City | WILLIMANTIC
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State | CT
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Zip | 06226-1940
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Country | US
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Telephone | 860-450-1823
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Fax |
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Authorized Official
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Title or Position | LABORATORY MANAGER
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Name | MRS. CHRISTINE R COBLE
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Credential | M.S., CT (ASCP)
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Telephone | 860-450-1823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | CL0465
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License Number State | CT
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