33D2169905 CLIA NUMBER - CNY FAMILY NURSE PRACTITIONER HOME AND OFFICE SERVICES, PC

Laboratory Demographics

CLIA Number: 33D2169905

Facility Name: CNY FAMILY NURSE PRACTITIONER HOME AND OFFICE SERVICES, PC

Facility Address:
1 MILL STREET
NEW HARTFORD, NY
ZIP 13413
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Facility Phone Number: 315 798-1260

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1609227149

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	33D2169905
LAB Type	Physician Office
Facility Name	CNY FAMILY NURSE PRACTITIONER HOME AND OFFICE SERVICES, PC
Street	1 MILL STREET
City	NEW HARTFORD
State	NY
ZIP	13413
Phone	315 798-1260
CertificateType	4
CertificateEffectiveDate	7/30/2023
CertificateExpirationDate	7/29/2025
FacilityType	Waiver

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