Triborough ASC LLC
Director
							Mark Gladstein, M.D.
			Expiration Date
							Phone Number
							(747) 239-4040
			UID (Facility ID - Site ID)
							Y709-0000
			Site ID
							0000
			City
							Bronx
			CLIA Number
							33D2184417
			Street Address
							550 E 180th St
			State
							NY
			Zip Code
							10457
			County
							Bronx
			Country
							United States
			Primary Contact
							Victoria Frenkel
			Contact Phone Number
							(718) 724-9759
			Certificate Type
							WAIVER
			Tests
				Drugs of Abuse
							Glucose
							Pregnancy Test (Urine)
					Facility ID
							Y709
			