33D2267900 CLIA NUMBER - BL PAIN MANAGEMENT PLLC

Laboratory Demographics

  • CLIA Code: 33D2267900
  • Facility Name: BL PAIN MANAGEMENT PLLC
  • Facility Address: 1976 CROTONA PARKWAY SUITE 3A
    BRONX, NY
    ZIP 10460
  • Facility Phone: 718 645-2829
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BOLESLAV KOSHARSKYY
  • NPI Number: 1922509769
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D2267900
LAB Type Physician Office
Facility Name BL PAIN MANAGEMENT PLLC
Street 1976 CROTONA PARKWAY SUITE 3A
City BRONX
State NY
ZIP 10460
Phone 718 645-2829
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2024
Certificate Expiration Date 9/1/2026
Facility Type Physician Office
Lab Director BOLESLAV KOSHARSKYY

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