33D2045260 CLIA NUMBER - TABASCO FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 33D2045260
  • Facility Name: TABASCO FAMILY PRACTICE
  • Facility Address: 5 GOLDEN LANE
    KERHONKSON, NY
    ZIP 12446
  • Facility Phone: 845 626-3424
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. LUCINDA B. GROVENBURG
  • NPI Number: 1073701579
  • Taxonomy: 207QA0401X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D2045260
LAB Type Physician Office
Facility Name TABASCO FAMILY PRACTICE
Street 5 GOLDEN LANE
City KERHONKSON
State NY
ZIP 12446
Phone 845 626-3424
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2024
Certificate Expiration Date 8/8/2026
Facility Type Physician Office
Lab Director DR. LUCINDA B. GROVENBURG

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