33D0967503 CLIA NUMBER - OLV HUMAN SERVICES

Laboratory Demographics

  • CLIA Code: 33D0967503
  • Facility Name: OLV HUMAN SERVICES
  • Facility Address: 150 MARTIN RD
    LACKAWANNA, NY
    ZIP 14218
  • Facility Phone: 716 828-9500
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. GAIL GOODMAN
  • NPI Number: 1124482344
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 33D0967503
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name OLV HUMAN SERVICES
Street 150 MARTIN RD
City LACKAWANNA
State NY
ZIP 14218
Phone 716 828-9500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2004
Certificate Expiration Date 3/26/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. GAIL GOODMAN

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