33D0146454 CLIA NUMBER - OLITSA ROTH MD

Laboratory Demographics

  • CLIA Code: 33D0146454
  • Facility Name: OLITSA ROTH MD
  • Facility Address: 5211 15TH AVENUE
    BROOKLYN, NY
    ZIP 11219
  • Facility Phone: 718 851-7444
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. OLITSA ROTH
  • NPI Number: 1669402061
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 33D0146454
LAB Type Physician Office
Facility Name OLITSA ROTH MD
Street 5211 15TH AVENUE
City BROOKLYN
State NY
ZIP 11219
Phone 718 851-7444
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 1/20/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director DR. OLITSA ROTH

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