33D0962091 CLIA NUMBER - NCRNC LLC DBA NORTHEAST CTR FOR REHAB AND BRAIN INJURY

Laboratory Demographics

  • CLIA Code: 33D0962091
  • Facility Name: NCRNC LLC DBA NORTHEAST CTR FOR REHAB AND BRAIN INJURY
  • Facility Address: 300 GRANT AVE
    LAKE KATRINE, NY
    ZIP 12449
  • Facility Phone: 914 336-3500
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. ALBERT L. RIDDLE
  • NPI Number: 1194015453
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 33D0962091
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name NCRNC LLC DBA NORTHEAST CTR FOR REHAB AND BRAIN INJURY
Street 300 GRANT AVE
City LAKE KATRINE
State NY
ZIP 12449
Phone 914 336-3500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/1999
Certificate Expiration Date 3/26/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. ALBERT L. RIDDLE

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