33D2152040 CLIA NUMBER - CITY MEDICAL OF UPPER EAST SIDE PLLC

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Laboratory Demographics

CLIA Number: 33D2152040

Facility Name: CITY MEDICAL OF UPPER EAST SIDE PLLC

Facility Address:
1470 METROPOLITAN AVE
BRONX, NY
ZIP 10462
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Facility Phone Number: 516 453-0435

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1336637420

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2152040
LAB Type	Physician Office
Facility Name	CITY MEDICAL OF UPPER EAST SIDE PLLC
Street	1470 METROPOLITAN AVE
City	BRONX
State	NY
ZIP	10462
Phone	516 453-0435
CertificateType	4
CertificateEffectiveDate	8/2/2018
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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