33D1079306 CLIA NUMBER - FADMO HEALTH AND HOMECARE AGENCY

Laboratory Demographics

CLIA Number: 33D1079306

Facility Name: FADMO HEALTH AND HOMECARE AGENCY

Facility Address:
194 TARGEE STREET
STATEN ISLAND, NY
ZIP 10304
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Facility Phone Number: 718 390-0561

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1073679205

Taxonomy: 251F00000X - Home Infusion

CLIA Record

Field Name	Field Value
CLIA Number	33D1079306
LAB Type	Home Health Agency
Facility Name	FADMO HEALTH AND HOMECARE AGENCY
Street	194 TARGEE STREET
City	STATEN ISLAND
State	NY
ZIP	10304
Phone	718 390-0561
CertificateType	4
CertificateEffectiveDate	1/30/2008
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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