33D0975420 CLIA NUMBER - LAKE CITY PRIMARY CARE ASSOCIATES

Laboratory Demographics

CLIA Number: 33D0975420

Facility Name: LAKE CITY PRIMARY CARE ASSOCIATES

Facility Address:
16 DEGRANDPRE WAY, SUITE 300
PLATTSBURGH, NY
ZIP 12901
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Facility Phone Number: 518 561-8256

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1164850053

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	33D0975420
LAB Type	Physician Office
Facility Name	LAKE CITY PRIMARY CARE ASSOCIATES
Street	16 DEGRANDPRE WAY, SUITE 300
City	PLATTSBURGH
State	NY
ZIP	12901
Phone	518 561-8256
CertificateType	4
CertificateEffectiveDate	7/7/2022
CertificateExpirationDate	7/6/2024
FacilityType	Waiver

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