33D2256180 CLIA NUMBER - INTREPID LANE AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 33D2256180
  • Facility Name: INTREPID LANE AMBULATORY SURGERY CENTER
  • Facility Address: 190 INTREPID LANE
    SYRACUSE, NY
    ZIP 13205
  • Facility Phone: 315 760-3200
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. BENJAMIN R. MCHONE
  • NPI Number: 1184378846
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D2256180
LAB Type Ambulatory Surgery Center
Facility Name INTREPID LANE AMBULATORY SURGERY CENTER
Street 190 INTREPID LANE
City SYRACUSE
State NY
ZIP 13205
Phone 315 760-3200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2022
Certificate Expiration Date 3/26/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. BENJAMIN R. MCHONE

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