33D0672849 CLIA NUMBER - PEDIATRICS WELLNESS OF NORTHERN NEW YORK

Laboratory Demographics

  • CLIA Code: 33D0672849
  • Facility Name: PEDIATRICS WELLNESS OF NORTHERN NEW YORK
  • Facility Address: 19474 HOWELL DR
    WATERTOWN, NY
    ZIP 13601
  • Facility Phone: 315 782-7330
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MYLA D. ESTEPA
  • NPI Number: 1750318705
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 33D0672849
LAB Type Physician Office
Facility Name PEDIATRICS WELLNESS OF NORTHERN NEW YORK
Street 19474 HOWELL DR
City WATERTOWN
State NY
ZIP 13601
Phone 315 782-7330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2025
Certificate Expiration Date 5/21/2027
Facility Type Physician Office
Lab Director DR. MYLA D. ESTEPA

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