33D2166175 CLIA NUMBER - CITY MEDICAL OF UPPER EAST SIDE PLLC

Laboratory Demographics

CLIA Number: 33D2166175

Facility Name: CITY MEDICAL OF UPPER EAST SIDE PLLC

Facility Address:
2 W FORDHAM
BRONX, NY
ZIP 10468
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Facility Phone Number: 646 647-1255

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1497310718

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2166175
LAB Type	Physician Office
Facility Name	CITY MEDICAL OF UPPER EAST SIDE PLLC
Street	2 W FORDHAM
City	BRONX
State	NY
ZIP	10468
Phone	646 647-1255
CertificateType	4
CertificateEffectiveDate	5/14/2019
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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