33D0713520 CLIA NUMBER - PINE HAVEN NURSING AND REHABILITATION CENTER

Laboratory Demographics

  • CLIA Code: 33D0713520
  • Facility Name: PINE HAVEN NURSING AND REHABILITATION CENTER
  • Facility Address: 201 MAIN STREET
    PHILMONT, NY
    ZIP 12565
  • Facility Phone: 518 672-7408
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. ANANTHAKRISHNA RAMANI
  • NPI Number: 1265880603
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 33D0713520
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PINE HAVEN NURSING AND REHABILITATION CENTER
Street 201 MAIN STREET
City PHILMONT
State NY
ZIP 12565
Phone 518 672-7408
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/1994
Certificate Expiration Date 3/26/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. ANANTHAKRISHNA RAMANI

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