33D2054683 CLIA NUMBER - VSVL MEDICAL SERVICES, PLLC DBA MANNAM MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 33D2054683
  • Facility Name: VSVL MEDICAL SERVICES, PLLC DBA MANNAM MEDICAL CENTER
  • Facility Address: 1170 CASTLE HILL AVENUE
    BRONX, NY
    ZIP 10462
  • Facility Phone: (718) 792-6000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. PRASHANTH MANNAM
  • NPI Number: 1467706242
  • Taxonomy: 302F00000X - Exclusive Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 33D2054683
LAB Type Physician Office
Facility Name VSVL MEDICAL SERVICES, PLLC DBA MANNAM MEDICAL CENTER
Street 1170 CASTLE HILL AVENUE
City BRONX
State NY
ZIP 10462
Phone 7187926000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Physician Office
Lab Director DR. PRASHANTH MANNAM

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This page was last updated on: 5/18/2026