33D2209515 CLIA NUMBER - BETHANY MEDICAL CLINIC OF NEW YORK PLLC

Laboratory Demographics

  • CLIA Code: 33D2209515
  • Facility Name: BETHANY MEDICAL CLINIC OF NEW YORK PLLC
  • Facility Address: 200 W 57TH ST SUITE 601
    NEW YORK, NY
    ZIP 10019
  • Facility Phone: (315) 201-0621
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SHIRIN S. PETERS
  • NPI Number: 1548873334
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 33D2209515
LAB Type Physician Office
Facility Name BETHANY MEDICAL CLINIC OF NEW YORK PLLC
Street 200 W 57TH ST SUITE 601
City NEW YORK
State NY
ZIP 10019
Phone 3152010621
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2025
Certificate Expiration Date 1/13/2027
Facility Type Physician Office
Lab Director DR. SHIRIN S. PETERS

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This page was last updated on: 5/18/2026