33D2052596 CLIA NUMBER - ACTIVE CARE PHYSICIAN, PC

Laboratory Demographics

  • CLIA Code: 33D2052596
  • Facility Name: ACTIVE CARE PHYSICIAN, PC
  • Facility Address: 70 BOWERY STREET, ROOM 404
    NEW YORK, NY
    ZIP 10013
  • Facility Phone: 212 343-8290
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BLANCHE LEUNG
  • NPI Number: 1912244567
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D2052596
LAB Type Physician Office
Facility Name ACTIVE CARE PHYSICIAN, PC
Street 70 BOWERY STREET, ROOM 404
City NEW YORK
State NY
ZIP 10013
Phone 212 343-8290
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2025
Certificate Expiration Date 1/14/2027
Facility Type Physician Office
Lab Director BLANCHE LEUNG

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