33D0998153 CLIA NUMBER - ST PETERS AMBULATORY SURGERY CENTER LLC

Laboratory Demographics

CLIA Number: 33D0998153

Facility Name: ST PETERS AMBULATORY SURGERY CENTER LLC

Facility Address:
1375 WASHINGTON AVE - SUITE 201
ALBANY, NY
ZIP 12206
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Facility Phone Number: 518 533-3420

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1750376836

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D0998153
LAB Type	Ambulatory Surgery Center
Facility Name	ST PETERS AMBULATORY SURGERY CENTER LLC
Street	1375 WASHINGTON AVE - SUITE 201
City	ALBANY
State	NY
ZIP	12206
Phone	518 533-3420
CertificateType	4
CertificateEffectiveDate	4/8/2002
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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