33D0155352 CLIA NUMBER - OPTUM MEDICAL CARE PC

Laboratory Demographics

  • CLIA Code: 33D0155352
  • Facility Name: OPTUM MEDICAL CARE PC
  • Facility Address: 123 STEWART AVENUE
    HICKSVILLE, NY
    ZIP 11801
  • Facility Phone: 516 433-0770
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JOHN F. ROTHAR
  • NPI Number: 1518092352
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D0155352
LAB Type Physician Office
Facility Name OPTUM MEDICAL CARE PC
Street 123 STEWART AVENUE
City HICKSVILLE
State NY
ZIP 11801
Phone 516 433-0770
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/8/2025
Certificate Expiration Date 10/7/2027
Facility Type Physician Office
Lab Director DR. JOHN F. ROTHAR

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