33D1084447 CLIA NUMBER - VILLAGE PEDIATRIC GROUP

Laboratory Demographics

  • CLIA Code: 33D1084447
  • Facility Name: VILLAGE PEDIATRIC GROUP
  • Facility Address: 115 MAIN ST - SUITE 301
    TUCKAHOE, NY
    ZIP 10707
  • Facility Phone: 914 771-7070
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. HEATHER A. MCGOWEN
  • NPI Number: 1861626210
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 33D1084447
LAB Type Physician Office
Facility Name VILLAGE PEDIATRIC GROUP
Street 115 MAIN ST - SUITE 301
City TUCKAHOE
State NY
ZIP 10707
Phone 914 771-7070
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2019
Certificate Expiration Date 3/26/2027
Facility Type Physician Office
Lab Director DR. HEATHER A. MCGOWEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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