Elizabethtown Lewis Emergency Squad Inc
Director
							Laura A Mulvey, M.D.
			Expiration Date
							Phone Number
							(518) 873-2122
			UID (Facility ID - Site ID)
							H408-0000
			Site ID
							0000
			City
							Lewis
			CLIA Number
							33D2331948
			Street Address
							8143 US Rte 9
			State
							NY
			Zip Code
							12950
			County
							Essex
			Country
							United States
			Primary Contact
							Patty Bashaw
			Contact Phone Number
							(518) 572-4705
			Certificate Type
							WAIVER
			Tests
				Glucose
					Facility ID
							H408