33D2095562 CLIA NUMBER - MSKCC CLINICAL LABORATORY AT JOSIE ROBERTSON - LIMITED

Laboratory Demographics

  • CLIA Code: 33D2095562
  • Facility Name: MSKCC CLINICAL LABORATORY AT JOSIE ROBERTSON - LIMITED
  • Facility Address: 1133 YORK AVENUE
    NEW YORK, NY
    ZIP 10065
  • Facility Phone: 212 639-7245
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. SCOTT T. AVECILLA
  • NPI Number: 1629200035
  • Taxonomy: 284300000X - Special Hospital

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CLIA Record

Field Name Field Value
CLIA Number 33D2095562
LAB Type Ambulatory Surgery Center
Facility Name MSKCC CLINICAL LABORATORY AT JOSIE ROBERTSON - LIMITED
Street 1133 YORK AVENUE
City NEW YORK
State NY
ZIP 10065
Phone 212 639-7245
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2015
Certificate Expiration Date 3/26/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. SCOTT T. AVECILLA

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