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Organization

UNIVERSITY OF CONNECTICUT HEALTH CENTER

Active
Other names
Dermatopathology Laboratory
Organization subpart
No

Provider details

NPI number
Authorized official
DENIS C LAFRENIERE MD (MEDICAL DIRECTOR)
(860) 679-7503
Entity
Organization

Contact information

Practice address
21 SOUTH RD, DERMATOPATHOLOGY LABORATORY, FARMINGTON, CT 06032-2482
(860) 679-4600
(860) 679-1248
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
021687
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1216878
CT
Enumeration date
11/25/2005
Last updated
11/17/2015
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