33D0873021 CLIA NUMBER - KENTON FAMILY CARE

Laboratory Demographics

CLIA Number: 33D0873021

Facility Name: KENTON FAMILY CARE

Facility Address:
2625 DELAWARE AVE - SUITE 124
BUFFALO, NY
ZIP 14216
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Facility Phone Number: 716 447-6450

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Waiver

NPI Number: 1821263518

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D0873021
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	KENTON FAMILY CARE
Street	2625 DELAWARE AVE - SUITE 124
City	BUFFALO
State	NY
ZIP	14216
Phone	716 447-6450
CertificateType	4
CertificateEffectiveDate	8/24/2016
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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