33D0670196 CLIA NUMBER - PUTNAM PEDIATRIC OF BCHP

Laboratory Demographics

  • CLIA Code: 33D0670196
  • Facility Name: PUTNAM PEDIATRIC OF BCHP
  • Facility Address: 667 STONELEIGH AVE - SUITE 111
    CARMEL, NY
    ZIP 10512
  • Facility Phone: 845 279-9652
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. LALAINE C. MORTERA
  • NPI Number: 1508131418
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 33D0670196
LAB Type Physician Office
Facility Name PUTNAM PEDIATRIC OF BCHP
Street 667 STONELEIGH AVE - SUITE 111
City CARMEL
State NY
ZIP 10512
Phone 845 279-9652
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2019
Certificate Expiration Date 3/26/2027
Facility Type Physician Office
Lab Director DR. LALAINE C. MORTERA

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