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33D1013128 CLIA NUMBER - OCCUPATIONAL & ENVIRONMENTAL HEALTH CENTER OF EASTERN NEW YORK

Laboratory Demographics

CLIA Number: 33D1013128

Facility Name: OCCUPATIONAL & ENVIRONMENTAL HEALTH CENTER OF EASTERN NEW YORK

Facility Address:
1873 WESTERN AVE - SUITE 100
ALBANY, NY
ZIP 12203
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Facility Phone Number: 518 690-4420

Facility Type: Community Clinic

Certificate Type: Waiver
NPI Number: 1275833410

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 33D1013128
LAB Type Community Clinic
Facility Name OCCUPATIONAL & ENVIRONMENTAL HEALTH CENTER OF EASTERN NEW YORK
Street 1873 WESTERN AVE - SUITE 100
City ALBANY
State NY
ZIP 12203
Phone 518 690-4420
CertificateType 4
CertificateEffectiveDate 6/2/2003
CertificateExpirationDate 3/26/2027
FacilityType Waiver

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