33D2079888 CLIA NUMBER - BRONX SC LLC

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Laboratory Demographics

CLIA Number: 33D2079888

Facility Name: BRONX SC LLC

Facility Address:
3170 WEBSTER AVENUE
BRONX, NY
ZIP 10467
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Facility Phone Number: 718 708-5777

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1720407273

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2079888
LAB Type	Ambulatory Surgery Center
Facility Name	BRONX SC LLC
Street	3170 WEBSTER AVENUE
City	BRONX
State	NY
ZIP	10467
Phone	718 708-5777
CertificateType	4
CertificateEffectiveDate	6/26/2014
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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