33D2122427 CLIA NUMBER - MEDICAL GROUP OF NEW YORK PC

Laboratory Demographics

  • CLIA Code: 33D2122427
  • Facility Name: MEDICAL GROUP OF NEW YORK PC
  • Facility Address: 130 LENOX AVE
    NEW YORK, NY
    ZIP 10026
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. DAVID G. FAIRCHILD
  • NPI Number: 1487983516
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 33D2122427
LAB Type Pharmacy
Facility Name MEDICAL GROUP OF NEW YORK PC
Street 130 LENOX AVE
City NEW YORK
State NY
ZIP 10026
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2016
Certificate Expiration Date 3/26/2027
Facility Type Pharmacy
Lab Director DR. DAVID G. FAIRCHILD

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This page was last updated on: 3/20/2025