Organization
COLLABORATIVE LABORATORY SERVICES-MOUNT SINAI CAMPUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD STRACESKI (VICE PRESIDENT OF FINANCIAL MANAGE)
(860) 714-4609
Entity
Organization
Contact information
Practice address
114 WOODLAND ST, HARTFORD, CT 06105-1208
(860) 714-2802
Mailing address
500 BLUE HILLS AVE, HARTFORD, CT 06112-1500
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CL-0625
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2V4067
HEALTHNET
CT
Enumeration date
08/03/2006
Last updated
08/22/2020
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