33D2215405 CLIA NUMBER - WATERVLIET PHARMACY ACQUISITION LLC

Laboratory Demographics

  • CLIA Code: 33D2215405
  • Facility Name: WATERVLIET PHARMACY ACQUISITION LLC
  • Facility Address: 601 9TH ST
    WATERVLIET, NY
    ZIP 12189
  • Facility Phone: 518 273-1402
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SEAN P. ROCHE
  • NPI Number: 1144335183
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2215405
LAB Type Pharmacy
Facility Name WATERVLIET PHARMACY ACQUISITION LLC
Street 601 9TH ST
City WATERVLIET
State NY
ZIP 12189
Phone 518 273-1402
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2021
Certificate Expiration Date 3/26/2027
Facility Type Pharmacy
Lab Director SEAN P. ROCHE

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