33D0154593 CLIA NUMBER - CHARLES A MITGANG MD PC

Laboratory Demographics

  • CLIA Code: 33D0154593
  • Facility Name: CHARLES A MITGANG MD PC
  • Facility Address: 371 MERRICK ROAD SUITE 407
    ROCKVILLE CENTRE, NY
    ZIP 11570
  • Facility Phone: 516 678-5555
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CHARLES A. MITGANG
  • NPI Number: 1114923315
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D0154593
LAB Type Physician Office
Facility Name CHARLES A MITGANG MD PC
Street 371 MERRICK ROAD SUITE 407
City ROCKVILLE CENTRE
State NY
ZIP 11570
Phone 516 678-5555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2025
Certificate Expiration Date 6/4/2027
Facility Type Physician Office
Lab Director DR. CHARLES A. MITGANG

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