33D2161460 CLIA NUMBER - CAMILLUS RIDGE TERRACE

Laboratory Demographics

CLIA Number: 33D2161460

Facility Name: CAMILLUS RIDGE TERRACE

Facility Address:
2453 W GENESEE TURNPIKE
CAMILLUS, NY
ZIP 13031
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Facility Phone Number: 315 672-3790

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1336629179

Taxonomy: 225700000X - Massage Therapist
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

CLIA Record

Field Name	Field Value
CLIA Number	33D2161460
LAB Type	Assisted Living Facility
Facility Name	CAMILLUS RIDGE TERRACE
Street	2453 W GENESEE TURNPIKE
City	CAMILLUS
State	NY
ZIP	13031
Phone	315 672-3790
CertificateType	4
CertificateEffectiveDate	2/4/2019
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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