33D2130757 CLIA NUMBER - CHURCHILL MANOR

Laboratory Demographics

  • CLIA Code: 33D2130757
  • Facility Name: CHURCHILL MANOR
  • Facility Address: 750 E BRIGHTON AVE
    SYRACUSE, NY
    ZIP 13205
  • Facility Phone: (315) 492-1329
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DR. DAVID D. HEISIG
  • NPI Number: 1851590830
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 33D2130757
LAB Type Assisted Living Facility
Facility Name CHURCHILL MANOR
Street 750 E BRIGHTON AVE
City SYRACUSE
State NY
ZIP 13205
Phone 3154921329
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2017
Certificate Expiration Date 3/26/2027
Facility Type Assisted Living Facility
Lab Director DR. DAVID D. HEISIG

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This page was last updated on: 5/18/2026