33D2172557 CLIA NUMBER - WHITE PLAINS MEDICAL SERVICES DBA SCARSDALE MEDICAL GROUP

Laboratory Demographics

CLIA Code: 33D2172557
Facility Name: WHITE PLAINS MEDICAL SERVICES DBA SCARSDALE MEDICAL GROUP
Facility Address: 550 MAMARONECK AVE
HARRISON, NY
ZIP 10528
Facility Phone: 914 723-8100
Facility Type: Ancillary Testing Site in Health Care Center
Facility Type: Microscopy
Lab Director: DR. DORIAN L. GRAVENESE
NPI Number: 1003355207
Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name	Field Value
CLIA Number	33D2172557
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	WHITE PLAINS MEDICAL SERVICES DBA SCARSDALE MEDICAL GROUP
Street	550 MAMARONECK AVE
City	HARRISON
State	NY
ZIP	10528
Phone	914 723-8100
Certificate Type	Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description	This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date	9/25/2019
Certificate Expiration Date	3/26/2027
Facility Type	Ancillary Testing Site in Health Care Center
Lab Director	DR. DORIAN L. GRAVENESE

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