33D2186737 CLIA NUMBER - HEALTHSOURCE PHARMACY INC

Laboratory Demographics

  • CLIA Code: 33D2186737
  • Facility Name: HEALTHSOURCE PHARMACY INC
  • Facility Address: 1296 SECOND AVE
    NEW YORK, NY
    ZIP 10065
  • Facility Phone: 212 794-8700
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. LINDA NIYAZOV
  • NPI Number: 1770695876
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2186737
LAB Type Pharmacy
Facility Name HEALTHSOURCE PHARMACY INC
Street 1296 SECOND AVE
City NEW YORK
State NY
ZIP 10065
Phone 212 794-8700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2020
Certificate Expiration Date 3/26/2027
Facility Type Pharmacy
Lab Director MS. LINDA NIYAZOV

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