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Organization

COLLABORATIVE LABORATORY SERVICES-BRISTOL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VALERIE POWELL-STAFFORD (PRESIDENT)
(860) 714-5387
Entity
Organization

Contact information

Practice address
BREWSTER ROAD, BRISTOL, CT 06011
(860) 585-3000
Mailing address
BREWSTER ROAD, BRISTOL, CT 06011

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CL-0622
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004225597
CT
01
00422559700
BLUE CROSS MANAGED MEDICA
CT
01
070CL0623CT02
ANTHEM BLUE CROSS & BLUE
CT
01
2V4067
HEALTHNET
CT
01
620109
CONNECTICARE
CT
01
N211376
PREFERRED ONE/FIRST CHOIC
CT
Enumeration date
10/20/2006
Last updated
02/17/2026
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