33D1094307 CLIA NUMBER - ADIRONDACK INTERVENTIONAL PHYSIATRY PC D/B/A CHAMPLAIN SPINE AND PAIN MANAGEMENT

Laboratory Demographics

  • CLIA Code: 33D1094307
  • Facility Name: ADIRONDACK INTERVENTIONAL PHYSIATRY PC D/B/A CHAMPLAIN SPINE AND PAIN MANAGEMENT
  • Facility Address: 4 FEATHERS DRIVE
    PLATTSBURGH, NY
    ZIP 12901
  • Facility Phone: 518 324-7246
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. THIERRY P. BONNABESSE
  • NPI Number: 1821166166
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D1094307
LAB Type Physician Office
Facility Name ADIRONDACK INTERVENTIONAL PHYSIATRY PC D/B/A CHAMPLAIN SPINE AND PAIN MANAGEMENT
Street 4 FEATHERS DRIVE
City PLATTSBURGH
State NY
ZIP 12901
Phone 518 324-7246
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2025
Certificate Expiration Date 1/14/2027
Facility Type Physician Office
Lab Director DR. THIERRY P. BONNABESSE

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