33D2154797 CLIA NUMBER - BUFFALO BEACON CORPORATION

Laboratory Demographics

  • CLIA Code: 33D2154797
  • Facility Name: BUFFALO BEACON CORPORATION
  • Facility Address: 210 S MAIN STREET
    HERKIMER, NY
    ZIP 13350
  • Facility Phone: 315 717-0189
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL DEJESUS
  • NPI Number: 1588063549
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 33D2154797
LAB Type Comp. Outpatient Rehab Facility
Facility Name BUFFALO BEACON CORPORATION
Street 210 S MAIN STREET
City HERKIMER
State NY
ZIP 13350
Phone 315 717-0189
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2018
Certificate Expiration Date 3/26/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director DR. MICHAEL DEJESUS

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This page was last updated on: 9/29/2025