33D2176080 CLIA NUMBER - TANGLEWOOD MANOR

Laboratory Demographics

  • CLIA Code: 33D2176080
  • Facility Name: TANGLEWOOD MANOR
  • Facility Address: 560 FAIRMOUNT AVE WE
    JAMESTOWN, NY
    ZIP 14701
  • Facility Phone: 716 483-2876
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DR. UMAMAHESWARA R. VEJENDLA
  • NPI Number: 1932302882
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 33D2176080
LAB Type Assisted Living Facility
Facility Name TANGLEWOOD MANOR
Street 560 FAIRMOUNT AVE WE
City JAMESTOWN
State NY
ZIP 14701
Phone 716 483-2876
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2019
Certificate Expiration Date 3/26/2027
Facility Type Assisted Living Facility
Lab Director DR. UMAMAHESWARA R. VEJENDLA

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