33D2033499 CLIA NUMBER - WESTERN NEW YORK IMMEDIATE MEDICAL CARE LLC

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Laboratory Demographics

CLIA Number: 33D2033499

Facility Name: WESTERN NEW YORK IMMEDIATE MEDICAL CARE LLC

Facility Address:
2228 DELAWARE AVENUE, SUITE 200
BUFFALO, NY
ZIP 14216
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Facility Phone Number: 716 874-2273

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1154496420

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	33D2033499
LAB Type	Physician Office
Facility Name	WESTERN NEW YORK IMMEDIATE MEDICAL CARE LLC
Street	2228 DELAWARE AVENUE, SUITE 200
City	BUFFALO
State	NY
ZIP	14216
Phone	716 874-2273
CertificateType	4
CertificateEffectiveDate	4/11/2023
CertificateExpirationDate	4/10/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024