33D0163303 CLIA NUMBER - OPTUM MEDICAL CARE PC

Laboratory Demographics

  • CLIA Code: 33D0163303
  • Facility Name: OPTUM MEDICAL CARE PC
  • Facility Address: 600 WESTAGE BUSINESS CENTER
    FISHKILL, NY
    ZIP 12524
  • Facility Phone: 845 279-7173
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. INGRID VAN HOLLEBEKE
  • NPI Number: 1982643003
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D0163303
LAB Type Physician Office
Facility Name OPTUM MEDICAL CARE PC
Street 600 WESTAGE BUSINESS CENTER
City FISHKILL
State NY
ZIP 12524
Phone 845 279-7173
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/1/2024
Certificate Expiration Date 11/30/2026
Facility Type Physician Office
Lab Director DR. INGRID VAN HOLLEBEKE

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