33D0909992 CLIA NUMBER - COVENANT HOUSE HEALTH SERVICES DEPARTMENT

Laboratory Demographics

  • CLIA Code: 33D0909992
  • Facility Name: COVENANT HOUSE HEALTH SERVICES DEPARTMENT
  • Facility Address: 460 W 41ST STREET
    NEW YORK, NY
    ZIP 10036
  • Facility Phone: 212 613-0315
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: NATHAN B. GAMMILL
  • NPI Number: 1053588988
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D0909992
LAB Type Community Clinic
Facility Name COVENANT HOUSE HEALTH SERVICES DEPARTMENT
Street 460 W 41ST STREET
City NEW YORK
State NY
ZIP 10036
Phone 212 613-0315
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/22/1995
Certificate Expiration Date 3/26/2027
Facility Type Community Clinic
Lab Director NATHAN B. GAMMILL

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