33D2192455 CLIA NUMBER - TUPPER LAKE FAMILY HEALTH

Laboratory Demographics

  • CLIA Code: 33D2192455
  • Facility Name: TUPPER LAKE FAMILY HEALTH
  • Facility Address: 7 STETSON RD
    TUPPER LAKE, NY
    ZIP 12986
  • Facility Phone: 518 359-7222
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: DR. WILLIAM M. BORGOS
  • NPI Number: 1164569117
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 33D2192455
LAB Type Federally Qualified Health Center
Facility Name TUPPER LAKE FAMILY HEALTH
Street 7 STETSON RD
City TUPPER LAKE
State NY
ZIP 12986
Phone 518 359-7222
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 9/10/2020
Certificate Expiration Date 3/26/2027
Facility Type Federally Qualified Health Center
Lab Director DR. WILLIAM M. BORGOS

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