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Ny. gov Web www. wadsworth. org/regulatory/clep/limited-service-lab-certs LABORATORY INFORMATION Laboratory PFI Number Effective Date of Change Laboratory Name PREVIOUS LABORATORY ADDRESS Street/City/State/Zip Code Street Address City State ZIP Code NEW LABORATORY ADDRESS Street/City/State/Zip Code Telephone Number Fax Number CERTIFICATION By signing this form I hereby certify that the information given is true and correct. O. Box 509 Notification of Change in Albany New York 12201-0509...
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