Organization
UNIVERSITY OF CONNECTICUT
Active
Organization
UNIVERSITY OF CONNECTICUT
Active
Other names
UConn Student Health Lab
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY ANDERSON M.D. (MEDICAL DIRECTOR)
(860) 486-0765
Entity
Organization
Contact information
Practice address
234 GLENBROOK RD UNIT 4011, STORRS, CT 06269-4011
(860) 486-0730
(860) 486-4076
Mailing address
234 GLENBROOK RD UNIT 4011, STORRS, CT 06269-4011
(860) 486-0730
(860) 486-4076
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CL-0378
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07D0716469
CLIA
CT
01
—
CL-0378
LABORATORY LICENSE
CT
Enumeration date
03/18/2016
Last updated
03/18/2016
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