33D2078343 CLIA NUMBER - CITY MEDICAL OF UPPER EAST SIDE PLLC

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Laboratory Demographics

CLIA Number: 33D2078343

Facility Name: CITY MEDICAL OF UPPER EAST SIDE PLLC

Facility Address:
193 W 237TH STREET
BRONX, NY
ZIP 10463
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Facility Phone Number: 718 303-0479

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1801207998

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2078343
LAB Type	Physician Office
Facility Name	CITY MEDICAL OF UPPER EAST SIDE PLLC
Street	193 W 237TH STREET
City	BRONX
State	NY
ZIP	10463
Phone	718 303-0479
CertificateType	4
CertificateEffectiveDate	5/31/2019
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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