33D0882589 CLIA NUMBER - TUPPER LAKE CENTER FOR NURSING AND REHABILITATION

Laboratory Demographics

  • CLIA Code: 33D0882589
  • Facility Name: TUPPER LAKE CENTER FOR NURSING AND REHABILITATION
  • Facility Address: 114 WAWBEEK AVE
    TUPPER LAKE, NY
    ZIP 12986
  • Facility Phone: 518 359-3355
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. NEIL J. CICHETTI
  • NPI Number: 1356115554
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 33D0882589
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name TUPPER LAKE CENTER FOR NURSING AND REHABILITATION
Street 114 WAWBEEK AVE
City TUPPER LAKE
State NY
ZIP 12986
Phone 518 359-3355
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2007
Certificate Expiration Date 3/26/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. NEIL J. CICHETTI

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