Moira Volunteer Fire and Rescue Department
PFI: S523
Secondary Site ID: 0041
Certification Type: WAIVER
Director: Tiffany Bombard, M.D.
Phone: (518) 529-6122
Fax: (518) 529-6183
Address: 2340 County Route 5, Moira, NY 12957
County: Franklin
Country: United States
Single or Primary Contact: Travis Howe
Contact Phone: (518) 529-6010
CLIA #: 33D1023278
Tests:
Blood Urea Nitrogen (BUN) Carbon Dioxide Chloride Community Screening Creatinine Glucose Hemoglobin Hematocrit Potassium Sodium
09/12/2019
Chateaugay Fire Company Inc
PFI: S523
Secondary Site ID: 0040
Certification Type: WAIVER
Director: Tiffany Bombard, M.D.
Phone: (518) 497-3135
Fax:
Address: 2 Lake St, Chateaugay, NY 12920
County: Franklin
Country: United States
Single or Primary Contact: Travis Howe
Contact Phone: (518) 497-3135
CLIA #: 33D1023278
Tests:
Blood Urea Nitrogen (BUN) Carbon Dioxide Chloride Community Screening Creatinine Glucose Hemoglobin Hematocrit Potassium Sodium
09/12/2019
Dannemora Fire Department
PFI: S523
Secondary Site ID: 0039
Certification Type: WAIVER
Director: Tiffany Bombard, M.D.
Phone: (518) 492-2381
Fax: (518) 492-2657
Address: 163 Emmons St, Dannemora, NY 12929
County: Clinton
Country: United States
Single or Primary Contact: Travis Howe
Contact Phone: (518) 492-2381
CLIA #: 33D1023278
Tests:
Blood Urea Nitrogen (BUN) Carbon Dioxide Chloride Community Screening Creatinine Glucose Hemoglobin Hematocrit Potassium Sodium
09/12/2019
Bombay Volunteer Rescue Squad
PFI: S523
Secondary Site ID: 0038
Certification Type: WAIVER
Director: Tiffany Bombard, M.D.
Phone: (518) 358-4213
Fax:
Address: 1856 State Rte 95, Bombay, NY 12914
County: Franklin
Country: United States
Single or Primary Contact: Travis Howe
Contact Phone: (518) 358-4213
CLIA #: 33D1023278
Tests:
Blood Urea Nitrogen (BUN) Carbon Dioxide Chloride Community Screening Creatinine Glucose Hemoglobin Hematocrit Potassium Sodium
09/12/2019
Newcomb Volunteer Fire and Rescue Squad Inc
PFI: S523
Secondary Site ID: 0035
Certification Type: WAIVER
Director: Tiffany Bombard, M.D.
Phone: (518) 582-4712
Fax: (518) 582-5044
Address: 20 Marcy Lane, Newcomb, NY 12852
County: Essex
Country: United States
Single or Primary Contact: Travis Howe
Contact Phone: (518) 582-2107
CLIA #: 33D1023278
Tests:
Blood Urea Nitrogen (BUN) Carbon Dioxide Chloride Community Screening Creatinine Glucose Hemoglobin Hematocrit Potassium Sodium
09/12/2019
Elizabethtown Lewis Emergency Squad
PFI: S523
Secondary Site ID: 0030
Certification Type: WAIVER
Director: Tiffany Bombard, M.D.
Phone: (518) 873-2122
Fax:
Address: 8143 US Rte 9, Lewis, NY 12950
County: Essex
Country: United States
Single or Primary Contact: Travis Howe
Contact Phone: (518) 873-2122
CLIA #: 33D1023278
Tests:
Blood Urea Nitrogen (BUN) Carbon Dioxide Chloride Community Screening Creatinine Glucose Hemoglobin Hematocrit Potassium Sodium
09/12/2019
Saranac Volunteer Fire Department EMS
PFI: S523
Secondary Site ID: 0026
Certification Type: WAIVER
Director: Tiffany Bombard, M.D.
Phone: (518) 293-8290
Fax:
Address: 3277 Rte 3, Saranac, NY 12981
County: Clinton
Country: United States
Single or Primary Contact: Travis Howe
Contact Phone: (518) 293-8290
CLIA #: 33D1023278
Tests:
Blood Urea Nitrogen (BUN) Carbon Dioxide Chloride Community Screening Creatinine Glucose Hemoglobin Hematocrit Potassium Sodium
09/12/2019
EMT of CVPH Inc
PFI: S523
Secondary Site ID: 0021
Certification Type: WAIVER
Director: Tiffany Bombard, M.D.
Phone: (518) 962-2698
Fax: (518) 562-7950
Address: 6708 Main St Trackside, Westport, NY 12993
County: Essex
Country: United States
Single or Primary Contact: Travis Howe
Contact Phone: (518) 962-4701
CLIA #: 33D1023278
Tests:
Blood Urea Nitrogen (BUN) Carbon Dioxide Chloride Community Screening Creatinine Glucose Hemoglobin Hematocrit Potassium Sodium
09/12/2019
Stony Creek Volunteer Fire Co Inc
PFI: S523
Secondary Site ID: 0012
Certification Type: WAIVER
Director: Tiffany Bombard, M.D.
Phone: (518) 696-3121
Fax:
Address: 42 Harrisburg Road, Stony Creek, NY 12878
County: Warren
Country: United States
Single or Primary Contact: Travis Howe
Contact Phone: (518) 696-3121
CLIA #: 33D1023278
Tests:
Blood Urea Nitrogen (BUN) Carbon Dioxide Chloride Community Screening Creatinine Glucose Hemoglobin Hematocrit Potassium Sodium
09/12/2019
Easton - Greenwich Rescue Squad
PFI: S523
Secondary Site ID: 0002
Certification Type: WAIVER
Director: Tiffany Bombard, M.D.
Phone: (518) 692-7118
Fax: (518) 692-7118
Address: 441 State Rte 29, Greenwich, NY 12834
County: Washington
Country: United States
Single or Primary Contact: Travis Howe
Contact Phone: (518) 692-7118
CLIA #: 33D1023278
Tests:
Blood Urea Nitrogen (BUN) Carbon Dioxide Chloride Community Screening Creatinine Glucose Hemoglobin Hematocrit Potassium Sodium
09/12/2019
Akwesasne Mohawk Ambulance
PFI: S523
Secondary Site ID: 0043
Certification Type: WAIVER
Director: Tiffany Bombard, M.D.
Phone: (613) 575-2341
Fax: (613) 575-1311
Address: 31 Hilltop Dr, Akwesasne, QC HOM1A0
County: Franklin
Country: United States
Single or Primary Contact: Travis Howe
Contact Phone: (613) 575-2341
CLIA #: 33D1023278
Tests:
Blood Urea Nitrogen (BUN) Carbon Dioxide Chloride Community Screening Creatinine Glucose Hemoglobin Hematocrit Potassium Sodium
09/12/2019
Keene EMS
PFI: S523
Secondary Site ID: 0010
Certification Type: WAIVER
Director: Tiffany Bombard, M.D.
Phone: (518) 576-4301
Fax: (518) 576-9346
Address: 1300 Hurricane Rd, Keene, NY 12942
County: Essex
Country: United States
Single or Primary Contact: Travis Howe
Contact Phone: (518) 576-4301
CLIA #: 33D1023278
Tests:
Blood Urea Nitrogen (BUN) Carbon Dioxide Chloride Community Screening Creatinine Glucose Hemoglobin Hematocrit Potassium Sodium
09/12/2019
Elizabethtown Community Hospital Transport
PFI: S523
Secondary Site ID: 0064
Certification Type: WAIVER
Director: Tiffany Bombard, M.D.
Phone: (518) 873-6377
Fax: (518) 873-2005
Address: 75 Park Street, Elizabethtown, NY 12932
County: Essex
Country: United States
Single or Primary Contact: Travis Howe
Contact Phone: (518) 873-3013
CLIA #: 33D1023278
Tests:
Blood Urea Nitrogen (BUN) Carbon Dioxide Chloride Community Screening Creatinine Glucose Hemoglobin Hematocrit Potassium Sodium
09/12/2019
Quality Health Center
PFI: S524
Secondary Site ID: 0003
Certification Type: WAIVER
Director: Robert B. Krausz, M.D.
Phone: (718) 387-2408
Fax: (718) 387-9222
Address: 432 Bedford Avenue, Brooklyn, NY 11211
County: Kings
Country: United States
Single or Primary Contact: Leah Wagshul
Contact Phone: 71838724085502
CLIA #: 33D1099409
Tests:
COVID-19 ANTIGEN Blood Lead Glucose Glycosylated Hemoglobin Hemoglobin Hematocrit Influenza Lyme Disease Antibodies Occult Blood Protime COVID-19 MOLECULAR RSV (Respiratory Syncytial Virus) Strep A Test Urinalysis Complete Blood Count
06/14/2027
ODA Primary Health Care Center Inc
PFI: S524
Secondary Site ID: 0000
Certification Type: WAIVER
Director: Robert B. Krausz, M.D.
Phone: (845) 434-2060
Fax: (845) 434-2020
Address: 6 Dairyland Road, Woodridge, NY 12789
County: Sullivan
Country: United States
Single or Primary Contact: Leah Wagshul
Contact Phone: (718) 260-4600
CLIA #: 33D1099409
Tests:
COVID-19 ANTIGEN Blood Lead Glucose Glycosylated Hemoglobin Hemoglobin Hematocrit Influenza Lyme Disease Antibodies Occult Blood Protime COVID-19 MOLECULAR RSV (Respiratory Syncytial Virus) Strep A Test Urinalysis Complete Blood Count
06/14/2027
ODA Crown Heights
PFI: S524
Secondary Site ID: 0006
Certification Type: WAIVER
Director: Robert B. Krausz, M.D.
Phone: (718) 260-4670
Fax: (718) 852-0867
Address: 779 East New York Ave, Brooklyn, NY 11203
County: Kings
Country: United States
Single or Primary Contact: Leah Wagshul
Contact Phone: 71826046001005
CLIA #: 33D1099409
Tests:
COVID-19 ANTIGEN Blood Lead Glucose Glycosylated Hemoglobin Hemoglobin Hematocrit Influenza Lyme Disease Antibodies Occult Blood Protime COVID-19 MOLECULAR RSV (Respiratory Syncytial Virus) Strep A Test Urinalysis Complete Blood Count
06/14/2027
Mobile Diagnostic and Treatment Center Extension Clinic
PFI: S524
Secondary Site ID: 0005
Certification Type: WAIVER
Director: Robert B. Krausz, M.D.
Phone: (718) 260-4600
Fax: (718) 852-0867
Address: 35 Franklin Ave, Brooklyn, NY 11205
County: Kings
Country: United States
Single or Primary Contact: Leah Wagshul
Contact Phone: 71826046001004
CLIA #: 33D1099409
Tests:
COVID-19 ANTIGEN Blood Lead Glucose Glycosylated Hemoglobin Hemoglobin Hematocrit Influenza Lyme Disease Antibodies Occult Blood Protime COVID-19 MOLECULAR RSV (Respiratory Syncytial Virus) Strep A Test Urinalysis Complete Blood Count
06/14/2027
ODA Kent Ave Multispecialty Wellness Center
PFI: S524
Secondary Site ID: 0004
Certification Type: WAIVER
Director: Robert B. Krausz, M.D.
Phone: (718) 260-4600
Fax: (718) 852-0867
Address: 74 Wallabout Street, Brooklyn, NY 11249
County: Kings
Country: United States
Single or Primary Contact: Leah Wagshul
Contact Phone:
CLIA #: 33D1099409
Tests:
COVID-19 ANTIGEN Blood Lead Glucose Glycosylated Hemoglobin Hemoglobin Hematocrit Influenza Lyme Disease Antibodies Occult Blood Protime COVID-19 MOLECULAR RSV (Respiratory Syncytial Virus) Strep A Test Urinalysis Complete Blood Count
06/14/2027
ODA Monticello
PFI: S524
Secondary Site ID: 0002
Certification Type: WAIVER
Director: Robert B. Krausz, M.D.
Phone: (845) 794-5090
Fax:
Address: 60 Jefferson St - Suite 1, Monticello, NY 12701
County: Sullivan
Country: United States
Single or Primary Contact: Leah Wagshul
Contact Phone: 7182604600305
CLIA #: 33D1099409
Tests:
COVID-19 ANTIGEN Blood Lead Glucose Glycosylated Hemoglobin Hemoglobin Hematocrit Influenza Lyme Disease Antibodies Occult Blood Protime COVID-19 MOLECULAR RSV (Respiratory Syncytial Virus) Strep A Test Urinalysis Complete Blood Count
06/14/2027
ODA Primary Health Care Center Park Ave Limited Service Laboratory
PFI: S524
Secondary Site ID: 0001
Certification Type: WAIVER
Director: Robert B. Krausz, M.D.
Phone: (718) 260-4600
Fax: (718) 852-0867
Address: 517 Park Avenue, Brooklyn, NY 11205
County: Kings
Country: United States
Single or Primary Contact: Leah Wagshul
Contact Phone: (718) 260-4600
CLIA #: 33D1099409
Tests:
COVID-19 ANTIGEN Blood Lead Glucose Glycosylated Hemoglobin Hemoglobin Hematocrit Influenza Lyme Disease Antibodies Occult Blood Protime COVID-19 MOLECULAR RSV (Respiratory Syncytial Virus) Strep A Test Urinalysis Complete Blood Count
06/14/2027