33D2314062 CLIA NUMBER - EMPIRE STATE MEDICAL WELLNESS PC

Laboratory Demographics

  • CLIA Code: 33D2314062
  • Facility Name: EMPIRE STATE MEDICAL WELLNESS PC
  • Facility Address: 517-B WEST 181ST STREET
    NEW YORK, NY
    ZIP 10033
  • Facility Phone: 347 808-2615
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RENE ERVIN
  • NPI Number: 1518746478
  • Taxonomy: 174400000X - Specialist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 33D2314062
LAB Type Physician Office
Facility Name EMPIRE STATE MEDICAL WELLNESS PC
Street 517-B WEST 181ST STREET
City NEW YORK
State NY
ZIP 10033
Phone 347 808-2615
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2024
Certificate Expiration Date 11/12/2026
Facility Type Physician Office
Lab Director DR. RENE ERVIN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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