33D0159935 CLIA NUMBER - RAJESH MARIWALLA PHYSICIAN PC

Laboratory Demographics

  • CLIA Code: 33D0159935
  • Facility Name: RAJESH MARIWALLA PHYSICIAN PC
  • Facility Address: 1111 MONTAUK HIGHWAY, SUITE 104
    WEST ISLIP, NY
    ZIP 11795
  • Facility Phone: 631 422-9600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RAJESH MARIWALLA
  • NPI Number: 1194719484
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 33D0159935
LAB Type Physician Office
Facility Name RAJESH MARIWALLA PHYSICIAN PC
Street 1111 MONTAUK HIGHWAY, SUITE 104
City WEST ISLIP
State NY
ZIP 11795
Phone 631 422-9600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2024
Certificate Expiration Date 12/31/2025
Facility Type Physician Office
Lab Director DR. RAJESH MARIWALLA

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