33D1082193 CLIA NUMBER - COMMUNITYCARE PHYSICIANS PC IMAGECARE - BALLTOWN

Laboratory Demographics

  • CLIA Code: 33D1082193
  • Facility Name: COMMUNITYCARE PHYSICIANS PC IMAGECARE - BALLTOWN
  • Facility Address: 2546 BALLTOWN ROAD SUITE 100
    NISKAYUNA, NY
    ZIP 12309
  • Facility Phone: 518 372-1344
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ERIC M. WAGLE
  • NPI Number: 1659528966
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 33D1082193
LAB Type Physician Office
Facility Name COMMUNITYCARE PHYSICIANS PC IMAGECARE - BALLTOWN
Street 2546 BALLTOWN ROAD SUITE 100
City NISKAYUNA
State NY
ZIP 12309
Phone 518 372-1344
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2024
Certificate Expiration Date 4/2/2026
Facility Type Physician Office
Lab Director DR. ERIC M. WAGLE

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This page was last updated on: 9/29/2025