33D2102789 CLIA NUMBER - NORTHERN STAR MEDICAL

Laboratory Demographics

CLIA Number: 33D2102789

Facility Name: NORTHERN STAR MEDICAL

Facility Address:
60 FINN ROAD - SUITE A
HENRIETTA, NY
ZIP 14467
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Facility Phone Number: 585 359-3200

Facility Type: Industrial

Certificate Type: Waiver

NPI Number: 1881283133

Taxonomy: 261QX0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2102789
LAB Type	Industrial
Facility Name	NORTHERN STAR MEDICAL
Street	60 FINN ROAD - SUITE A
City	HENRIETTA
State	NY
ZIP	14467
Phone	585 359-3200
CertificateType	4
CertificateEffectiveDate	9/29/2015
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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