33D2289542 CLIA NUMBER - MASTIC VOLUNTEER AMBULANCE COMPANY INC

Laboratory Demographics

CLIA Number: 33D2289542

Facility Name: MASTIC VOLUNTEER AMBULANCE COMPANY INC

Facility Address:
1630 MONTAUK HWY
MASTIC, NY
ZIP 11950
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Facility Phone Number: 516 523-5507

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1538700315

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	33D2289542
LAB Type	Ambulance
Facility Name	MASTIC VOLUNTEER AMBULANCE COMPANY INC
Street	1630 MONTAUK HWY
City	MASTIC
State	NY
ZIP	11950
Phone	516 523-5507
CertificateType	4
CertificateEffectiveDate	9/12/2023
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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