33D0692142 CLIA NUMBER - WANTAGH PEDIATRIC, PLLC

Laboratory Demographics

  • CLIA Code: 33D0692142
  • Facility Name: WANTAGH PEDIATRIC, PLLC
  • Facility Address: 2415 JERUSALEM AVENUE, SUITE 204
    NORTH BELLMORE, NY
    ZIP 11710
  • Facility Phone: 516 221-5151
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. SHAHANA KHAN
  • NPI Number: 1437227865
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 33D0692142
LAB Type Physician Office
Facility Name WANTAGH PEDIATRIC, PLLC
Street 2415 JERUSALEM AVENUE, SUITE 204
City NORTH BELLMORE
State NY
ZIP 11710
Phone 516 221-5151
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Physician Office
Lab Director DR. SHAHANA KHAN

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