33D2011866 CLIA NUMBER - GREENWOOD LAKE AMBULANCE INC

Laboratory Demographics

  • CLIA Code: 33D2011866
  • Facility Name: GREENWOOD LAKE AMBULANCE INC
  • Facility Address: 74 WINDERMERE AVENUE
    GREENWOOD LAKE, NY
    ZIP 10925
  • Facility Phone: 845 477-2200
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: DR. FRED S. REVOREDO
  • NPI Number: 1093049504
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 33D2011866
LAB Type Ambulance
Facility Name GREENWOOD LAKE AMBULANCE INC
Street 74 WINDERMERE AVENUE
City GREENWOOD LAKE
State NY
ZIP 10925
Phone 845 477-2200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2010
Certificate Expiration Date 3/26/2027
Facility Type Ambulance
Lab Director DR. FRED S. REVOREDO

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This page was last updated on: 6/4/2025