33D0168419 CLIA NUMBER - GOOD SHEPHERD - FAIRVIEW HOME

Laboratory Demographics

  • CLIA Code: 33D0168419
  • Facility Name: GOOD SHEPHERD - FAIRVIEW HOME
  • Facility Address: 80 FAIRVIEW AVE
    BINGHAMTON, NY
    ZIP 13904
  • Facility Phone: 607 724-2477
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. JEROME J. MIKLOUCICH
  • NPI Number: 1689826570
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 33D0168419
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GOOD SHEPHERD - FAIRVIEW HOME
Street 80 FAIRVIEW AVE
City BINGHAMTON
State NY
ZIP 13904
Phone 607 724-2477
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2006
Certificate Expiration Date 3/26/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. JEROME J. MIKLOUCICH

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This page was last updated on: 9/29/2025