33D2060414 CLIA NUMBER - MARY MANNING WALSH HOME

Laboratory Demographics

  • CLIA Code: 33D2060414
  • Facility Name: MARY MANNING WALSH HOME
  • Facility Address: 1339 YORK AVENUE
    NEW YORK, NY
    ZIP 10021
  • Facility Phone: 212 628-2800
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. TAIMUR MIRZA
  • NPI Number: 1245692185
  • Taxonomy: 305R00000X - Preferred Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 33D2060414
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MARY MANNING WALSH HOME
Street 1339 YORK AVENUE
City NEW YORK
State NY
ZIP 10021
Phone 212 628-2800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2013
Certificate Expiration Date 3/26/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. TAIMUR MIRZA

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