33D0666884 CLIA NUMBER - OPTUM MEDICAL CARE PC

Laboratory Demographics

  • CLIA Code: 33D0666884
  • Facility Name: OPTUM MEDICAL CARE PC
  • Facility Address: 1548 JERUSALEM AVENUE
    NORTH MERRICK, NY
    ZIP 11566
  • Facility Phone: 516 489-8060
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DANIEL M. ROSENTHAL
  • NPI Number: 1245467935
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 33D0666884
LAB Type Physician Office
Facility Name OPTUM MEDICAL CARE PC
Street 1548 JERUSALEM AVENUE
City NORTH MERRICK
State NY
ZIP 11566
Phone 516 489-8060
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/24/2025
Certificate Expiration Date 7/23/2027
Facility Type Physician Office
Lab Director DR. DANIEL M. ROSENTHAL

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