33D2212675 CLIA NUMBER - ELLISTON PEDIATRICS, PLLC

Laboratory Demographics

  • CLIA Code: 33D2212675
  • Facility Name: ELLISTON PEDIATRICS, PLLC
  • Facility Address: 20 RIVER TERRACE 27F
    NEW YORK, NY
    ZIP 10282
  • Facility Phone: 917 746-2455
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ANDREW ELLISTON
  • NPI Number: 1497369615
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 33D2212675
LAB Type Physician Office
Facility Name ELLISTON PEDIATRICS, PLLC
Street 20 RIVER TERRACE 27F
City NEW YORK
State NY
ZIP 10282
Phone 917 746-2455
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2021
Certificate Expiration Date 3/26/2027
Facility Type Physician Office
Lab Director DR. ANDREW ELLISTON

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