33D1094741 CLIA NUMBER - ASSOCIATED MEDICAL GROUP II

Laboratory Demographics

  • CLIA Code: 33D1094741
  • Facility Name: ASSOCIATED MEDICAL GROUP II
  • Facility Address: 140 WADSWORTH AVENUE
    NEW YORK, NY
    ZIP 10040
  • Facility Phone: 212 543-9700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BIENVENIDO FAJARDO
  • NPI Number: 1760655120
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D1094741
LAB Type Physician Office
Facility Name ASSOCIATED MEDICAL GROUP II
Street 140 WADSWORTH AVENUE
City NEW YORK
State NY
ZIP 10040
Phone 212 543-9700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2025
Certificate Expiration Date 1/25/2027
Facility Type Physician Office
Lab Director BIENVENIDO FAJARDO

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