33D0672849 CLIA NUMBER - WATERTOWN PEDIATRICS PC NORTH COUNTY MEDICAL CENTER

Laboratory Demographics

CLIA Number: 33D0672849

Facility Name: WATERTOWN PEDIATRICS PC NORTH COUNTY MEDICAL CENTER

Facility Address:
1571 WASHINGTON STREET, SUITE 107
WATERTOWN, NY
ZIP 13601
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Facility Phone Number: 315 782-7330

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1750318705

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	33D0672849
LAB Type	Physician Office
Facility Name	WATERTOWN PEDIATRICS PC NORTH COUNTY MEDICAL CENTER
Street	1571 WASHINGTON STREET, SUITE 107
City	WATERTOWN
State	NY
ZIP	13601
Phone	315 782-7330
CertificateType	2
CertificateEffectiveDate	3/14/2023
CertificateExpirationDate	3/13/2025
FacilityType	Compliance

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