33D2204707 CLIA NUMBER - LASALLE SCHOOL

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Laboratory Demographics

CLIA Number: 33D2204707

Facility Name: LASALLE SCHOOL

Facility Address:
391 WESTERN AVE
ALBANY, NY
ZIP 12205
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Facility Phone Number: 518 242-4731

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1316302284

Taxonomy: 261QM0855X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

CLIA Record

Field Name	Field Value
CLIA Number	33D2204707
LAB Type	School/Student Health Service
Facility Name	LASALLE SCHOOL
Street	391 WESTERN AVE
City	ALBANY
State	NY
ZIP	12205
Phone	518 242-4731
CertificateType	4
CertificateEffectiveDate	12/10/2020
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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