33D2183840 CLIA NUMBER - CITY MEDICAL OF UPPER EAST SIDE PLLC

Laboratory Demographics

CLIA Number: 33D2183840

Facility Name: CITY MEDICAL OF UPPER EAST SIDE PLLC

Facility Address:
3494 JEROME AVE
BRONX, NY
ZIP 10467
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Facility Phone Number: 718 571-9282

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1902425192

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2183840
LAB Type	Physician Office
Facility Name	CITY MEDICAL OF UPPER EAST SIDE PLLC
Street	3494 JEROME AVE
City	BRONX
State	NY
ZIP	10467
Phone	718 571-9282
CertificateType	4
CertificateEffectiveDate	5/11/2020
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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