33D1053652 CLIA NUMBER - BETH ISRAEL MEDICAL CENTER CLINIC 1

Laboratory Demographics

  • CLIA Code: 33D1053652
  • Facility Name: BETH ISRAEL MEDICAL CENTER CLINIC 1
  • Facility Address: 103 E 125 STREET
    NEW YORK, NY
    ZIP 10035
  • Facility Phone: 212 744-3210
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: DR. GRANT E. MITCHELL
  • NPI Number: 1528181187
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 33D1053652
LAB Type Ancillary Testing Site in Health Care Center
Facility Name BETH ISRAEL MEDICAL CENTER CLINIC 1
Street 103 E 125 STREET
City NEW YORK
State NY
ZIP 10035
Phone 212 744-3210
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2006
Certificate Expiration Date 3/26/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director DR. GRANT E. MITCHELL

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This page was last updated on: 3/20/2025