33D0171633 CLIA NUMBER - OAK ORCHARD COMMUNITY HEALTH CENTER INC

Laboratory Demographics

CLIA Number: 33D0171633

Facility Name: OAK ORCHARD COMMUNITY HEALTH CENTER INC

Facility Address:
300 WEST AVENUE
BROCKPORT, NY
ZIP 14420
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Facility Phone Number: 585 637-5319

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1558584458

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D0171633
LAB Type	Community Clinic
Facility Name	OAK ORCHARD COMMUNITY HEALTH CENTER INC
Street	300 WEST AVENUE
City	BROCKPORT
State	NY
ZIP	14420
Phone	585 637-5319
CertificateType	4
CertificateEffectiveDate	5/28/2021
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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This page was last updated on: 4/23/2024