33D1022925 CLIA NUMBER - CONCOURSE MEDICAL OFFICE PC

Laboratory Demographics

CLIA Number: 33D1022925

Facility Name: CONCOURSE MEDICAL OFFICE PC

Facility Address:
3184 GRAND CONCOURSE, SUITE 2E
BRONX, NY
ZIP 10458
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Facility Phone Number: 718 220-4380

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1568698132

Taxonomy: 207RP1001X - Internal Medicine
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

CLIA Record

Field Name	Field Value
CLIA Number	33D1022925
LAB Type	Physician Office
Facility Name	CONCOURSE MEDICAL OFFICE PC
Street	3184 GRAND CONCOURSE, SUITE 2E
City	BRONX
State	NY
ZIP	10458
Phone	718 220-4380
CertificateType	4
CertificateEffectiveDate	8/3/2023
CertificateExpirationDate	8/2/2025
FacilityType	Waiver

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