33D2193099 CLIA NUMBER - NARROW PATH FAMILY HEALTH NP PC

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Laboratory Demographics

CLIA Number: 33D2193099

Facility Name: NARROW PATH FAMILY HEALTH NP PC

Facility Address:
15 E MAIN ST
PORT JERVIS, NY
ZIP 12771
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Facility Phone Number: 845 672-4422

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1013529478

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	33D2193099
LAB Type	Physician Office
Facility Name	NARROW PATH FAMILY HEALTH NP PC
Street	15 E MAIN ST
City	PORT JERVIS
State	NY
ZIP	12771
Phone	845 672-4422
CertificateType	4
CertificateEffectiveDate	9/17/2022
CertificateExpirationDate	9/16/2024
FacilityType	Waiver

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