33D2236069 CLIA NUMBER - NEW YORK SPINE AND WELLNESS CENTER

Laboratory Demographics

CLIA Number: 33D2236069

Facility Name: NEW YORK SPINE AND WELLNESS CENTER

Facility Address:
5496 EAST TAFT RD
NORTH SYRACUSE, NY
ZIP 13212
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Facility Phone Number: 315 552-6700

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1487029815

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	33D2236069
LAB Type	Pharmacy
Facility Name	NEW YORK SPINE AND WELLNESS CENTER
Street	5496 EAST TAFT RD
City	NORTH SYRACUSE
State	NY
ZIP	13212
Phone	315 552-6700
CertificateType	4
CertificateEffectiveDate	9/14/2021
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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