33D2013177 CLIA NUMBER - COMMUNITY CARE WORKSITE CLINIC - DECRESENTE

Laboratory Demographics

  • CLIA Code: 33D2013177
  • Facility Name: COMMUNITY CARE WORKSITE CLINIC - DECRESENTE
  • Facility Address: 200 NORTH MAIN STREET
    MECHANICVILLE, NY
    ZIP 12118
  • Facility Phone: 518 664-1095
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RONALD V. MUSTO
  • NPI Number: 1982269478
  • Taxonomy: 207RR0500X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D2013177
LAB Type Physician Office
Facility Name COMMUNITY CARE WORKSITE CLINIC - DECRESENTE
Street 200 NORTH MAIN STREET
City MECHANICVILLE
State NY
ZIP 12118
Phone 518 664-1095
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/15/2024
Certificate Expiration Date 9/14/2026
Facility Type Physician Office
Lab Director DR. RONALD V. MUSTO

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