Organization
MILFORD MEDICAL LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL E MOSS (PRESIDENT)
(203) 876-4230
Entity
Organization
Contact information
Practice address
2068 BRIDGEPORT AVE, MILFORD, CT 06460-4634
(203) 876-7745
(203) 877-8319
Mailing address
2068 BRIDGEPORT AVE, MILFORD, CT 06460-4634
(203) 876-7745
(203) 877-8319
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CL-0502
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
721623
CONNECTICARE ID NUMBER
CT
01
—
CL-0502
STATE LICENSE NUMBER
CT
Enumeration date
07/01/2005
Last updated
08/22/2020
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