33D0139386 CLIA NUMBER - JACK I HERSHMAN MD

Laboratory Demographics

  • CLIA Code: 33D0139386
  • Facility Name: JACK I HERSHMAN MD
  • Facility Address: 777 N BROADWAY SUITE 309
    SLEEPY HOLLOW, NY
    ZIP 10591
  • Facility Phone: 914 631-3331
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JACK I. HERSHMAN
  • NPI Number: 1750333274
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 33D0139386
LAB Type Physician Office
Facility Name JACK I HERSHMAN MD
Street 777 N BROADWAY SUITE 309
City SLEEPY HOLLOW
State NY
ZIP 10591
Phone 914 631-3331
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/12/2025
Certificate Expiration Date 8/11/2027
Facility Type Physician Office
Lab Director DR. JACK I. HERSHMAN

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This page was last updated on: 9/29/2025