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33D0158777 CLIA NUMBER - MARK DI BENEDETTO MD

Laboratory Demographics

CLIA Number: 33D0158777

Facility Name: MARK DI BENEDETTO MD

Facility Address:
710 MAIN
PORT JEFFERSON, NY
ZIP 11777
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Facility Phone Number: 631 474-4000

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1619940269

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 33D0158777
LAB Type Physician Office
Facility Name MARK DI BENEDETTO MD
Street 710 MAIN
City PORT JEFFERSON
State NY
ZIP 11777
Phone 631 474-4000
CertificateType 4
CertificateEffectiveDate 1/21/2024
CertificateExpirationDate 1/20/2026
FacilityType Waiver

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This page was last updated on: 4/23/2024