33D2218889 CLIA NUMBER - RAQUETTE LAKE CAMPS

Laboratory Demographics

  • CLIA Code: 33D2218889
  • Facility Name: RAQUETTE LAKE CAMPS
  • Facility Address: 392 ANTLERS RD
    RAQUETTE LAKE, NY
    ZIP 13436
  • Facility Phone: 914 764-1500
  • Facility Type: Other - CHILDREN'S CAMP
  • Facility Type: Waiver
  • Lab Director: THOMAS N. LJUNGMAN
  • NPI Number: 1962492421
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 33D2218889
LAB Type Other - CHILDREN'S CAMP
Facility Name RAQUETTE LAKE CAMPS
Street 392 ANTLERS RD
City RAQUETTE LAKE
State NY
ZIP 13436
Phone 914 764-1500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2021
Certificate Expiration Date 3/26/2027
Facility Type Other - CHILDREN'S CAMP
Lab Director THOMAS N. LJUNGMAN

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