33D2054369 CLIA NUMBER - PLEASANT VALLEY FIRE DISTRICT RESCUE SQUAD

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Laboratory Demographics

CLIA Number: 33D2054369

Facility Name: PLEASANT VALLEY FIRE DISTRICT RESCUE SQUAD

Facility Address:
1619 MAIN STREET
PLEASANT VALLEY, NY
ZIP 12569
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Facility Phone Number: 845 635-9350

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1093273500

Taxonomy: 3336L0003X - Pharmacy
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

CLIA Record

Field Name	Field Value
CLIA Number	33D2054369
LAB Type	Ambulance
Facility Name	PLEASANT VALLEY FIRE DISTRICT RESCUE SQUAD
Street	1619 MAIN STREET
City	PLEASANT VALLEY
State	NY
ZIP	12569
Phone	845 635-9350
CertificateType	4
CertificateEffectiveDate	10/16/2017
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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