Provider Demographics
NPI:1710211974
Name:WELLINGTON CLINICAL LABORATORY CONSULTANTS, LLC
Entity Type:Organization
Organization Name:WELLINGTON CLINICAL LABORATORY CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:TINGHITELLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:203-877-9246
Mailing Address - Street 1:35 LEXINGTON WAY N
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-1855
Mailing Address - Country:US
Mailing Address - Phone:203-877-9246
Mailing Address - Fax:203-877-9584
Practice Address - Street 1:35 LEXINGTON WAY N
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06461-1855
Practice Address - Country:US
Practice Address - Phone:203-877-9246
Practice Address - Fax:203-877-9584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT586OtherCONNECTICUT LABORATORY DIRECTOR'S CERTIFICATE