33D0144835 CLIA NUMBER - CARLOS A MONTENEGRO MD PAN AMERICAN MEDICAL SERVICES

Laboratory Demographics

  • CLIA Code: 33D0144835
  • Facility Name: CARLOS A MONTENEGRO MD PAN AMERICAN MEDICAL SERVICES
  • Facility Address: 89-15 175TH STREET
    JAMAICA, NY
    ZIP 11432
  • Facility Phone: 718 739-4848
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CARLOS A. MONTENEGRO
  • NPI Number: 1427519768
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D0144835
LAB Type Physician Office
Facility Name CARLOS A MONTENEGRO MD PAN AMERICAN MEDICAL SERVICES
Street 89-15 175TH STREET
City JAMAICA
State NY
ZIP 11432
Phone 718 739-4848
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DR. CARLOS A. MONTENEGRO

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This page was last updated on: 6/4/2025