Black River Ambulance Squad Inc
Name
Black River Ambulance Squad Inc
Director
Maja L. Lundborg-Gray, M.D.
Expiration Date
Phone Number
(315) 773-4501
UID (Facility ID - Site ID)
S406-0000
Site ID
0000
City
Black River
CLIA Number
33D1102161
Street Address
121 Leray Street
State
NY
Zip Code
13612
County
Jefferson
Country
United States
Fax Number
(315) 775-0291
Primary Contact
Jeffrey S Lieberman, Sr.
Contact Phone Number
(315) 408-2007
Certificate Type
WAIVER
Tests
Glucose
Facility ID
S406