33D0950130 CLIA NUMBER - WADSWORTH MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 33D0950130
  • Facility Name: WADSWORTH MEDICAL GROUP
  • Facility Address: 860 GRAND CONCOURSE 1-K
    BRONX, NY
    ZIP 10451
  • Facility Phone: 212 781-5889
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RODOLFO W. GUZMAN
  • NPI Number: 1568648665
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 33D0950130
LAB Type Physician Office
Facility Name WADSWORTH MEDICAL GROUP
Street 860 GRAND CONCOURSE 1-K
City BRONX
State NY
ZIP 10451
Phone 212 781-5889
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2024
Certificate Expiration Date 8/18/2026
Facility Type Physician Office
Lab Director RODOLFO W. GUZMAN

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