33D0974285 CLIA NUMBER - LETTRICK FAMILY MEDICINE PLLC

Laboratory Demographics

CLIA Number: 33D0974285

Facility Name: LETTRICK FAMILY MEDICINE PLLC

Facility Address:
2500 POND VIEW ROAD, SUITE 103
CASTLETON, NY
ZIP 12033
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Facility Phone Number: 518 477-1191

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1164793808

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	33D0974285
LAB Type	Physician Office
Facility Name	LETTRICK FAMILY MEDICINE PLLC
Street	2500 POND VIEW ROAD, SUITE 103
City	CASTLETON
State	NY
ZIP	12033
Phone	518 477-1191
CertificateType	4
CertificateEffectiveDate	6/2/2022
CertificateExpirationDate	6/1/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024