33D2118404 CLIA NUMBER - CITY MEDICAL OF UPPER EAST SIDE PLLC

Laboratory Demographics

CLIA Number: 33D2118404

Facility Name: CITY MEDICAL OF UPPER EAST SIDE PLLC

Facility Address:
388 E FORDHAM ROAD
BRONX, NY
ZIP 10458
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Facility Phone Number: 718 489-3553

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1235686437

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2118404
LAB Type	Physician Office
Facility Name	CITY MEDICAL OF UPPER EAST SIDE PLLC
Street	388 E FORDHAM ROAD
City	BRONX
State	NY
ZIP	10458
Phone	718 489-3553
CertificateType	4
CertificateEffectiveDate	11/8/2018
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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