33D0691567 CLIA NUMBER - LONG ISLAND MEDICAL CARE SERVICES PC

Laboratory Demographics

CLIA Number: 33D0691567

Facility Name: LONG ISLAND MEDICAL CARE SERVICES PC

Facility Address:
910 RTE 109 - SUITE A
LINDENHURST, NY
ZIP 11757
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Facility Phone Number: 631 991-3235

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1639319122

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	33D0691567
LAB Type	Physician Office
Facility Name	LONG ISLAND MEDICAL CARE SERVICES PC
Street	910 RTE 109 - SUITE A
City	LINDENHURST
State	NY
ZIP	11757
Phone	631 991-3235
CertificateType	4
CertificateEffectiveDate	4/17/2020
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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