EAST LYME PEDIATRIC CLINIC, LLC
NPI 1326265745
Clinic/Center - Primary Care in Niantic, CT
About East Lyme Pediatric Clinic, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EAST LYME PEDIATRIC CLINIC, LLC (NPI 1326265745), doing business as East Lyme Pediatric Clinic, is a healthcare organization registered as a primary care in Niantic, Connecticut and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through July 1, 2027 and lists Sajda Perween Malik, Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 2
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 07D0962413
East Lyme Pediatric Clinic · Niantic, CTOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is East Lyme Pediatric Clinic, LLC's NPI number?
The NPI number for East Lyme Pediatric Clinic, LLC is 1326265745. It was assigned to this organization in the NPPES registry on April 19, 2007. The provider was formerly known as East Lyme Pediatric Clinic.
Where is East Lyme Pediatric Clinic, LLC located?
East Lyme Pediatric Clinic, LLC is located at 170 Flanders Rd, Niantic, CT 06357. The listed phone number is (860) 739-7444.
What is East Lyme Pediatric Clinic, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Does East Lyme Pediatric Clinic, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 07D0962413) is associated with this NPI, valid through July 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for East Lyme Pediatric Clinic, LLC was last updated on March 19, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# East Lyme Pediatric Clinic, Llc · NPI 1326265745
Primary Care organization in Niantic, Connecticut. Organization record, active in the CMS NPPES registry since April 19, 2007.
## Identity
- **NPI:** 1326265745 (Entity type: Organization)
- **Enumerated:** April 19, 2007
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Sajda Malik, MEMBER
## Practice location
- **Address:** 170 FLANDERS RD, Niantic, CT 06357-1208
- **Phone:** (860) 739-7444 · **Fax:** (860) 739-3252
## Record status
- **NPPES last updated:** March 19, 2013
- **Other identifiers:** Medicaid 001365263 (CT); Medicare UPIN G17142 (CT)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1326265745) · Data from the CMS NPPES public registry.