33D0665934 CLIA NUMBER - LACONIA NURSING HOME

Laboratory Demographics

  • CLIA Code: 33D0665934
  • Facility Name: LACONIA NURSING HOME
  • Facility Address: 1050 E 230TH STREET
    BRONX, NY
    ZIP 10466
  • Facility Phone: 718 654-5875
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. VIJAY V. KHATIWALA
  • NPI Number: 1457435877
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 33D0665934
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LACONIA NURSING HOME
Street 1050 E 230TH STREET
City BRONX
State NY
ZIP 10466
Phone 718 654-5875
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2001
Certificate Expiration Date 3/26/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. VIJAY V. KHATIWALA

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