33D0962443 CLIA NUMBER - CAMPHILL VILLAGE MEDICAL OFFICE

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Field Name	Field Value
CLIA Number	33D0962443
LAB Type	Community Clinic
Facility Name	CAMPHILL VILLAGE MEDICAL OFFICE
Street	84 CAMPHILL RD
City	COPAKE
State	NY
ZIP	12516
Phone	518 329-7776
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	7/6/1999
Certificate Expiration Date	3/26/2027
Facility Type	Community Clinic
Lab Director	DR. RONALD J. POPE

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