33D0866819 CLIA NUMBER - SCOTT P BLOOM MD PC

Laboratory Demographics

  • CLIA Code: 33D0866819
  • Facility Name: SCOTT P BLOOM MD PC
  • Facility Address: 380 NORTH BROADWAY - STE 307
    JERICHO, NY
    ZIP 11753
  • Facility Phone: 516 338-2900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SCOTT P. BLOOM
  • NPI Number: 1457432171
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D0866819
LAB Type Physician Office
Facility Name SCOTT P BLOOM MD PC
Street 380 NORTH BROADWAY - STE 307
City JERICHO
State NY
ZIP 11753
Phone 516 338-2900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2025
Certificate Expiration Date 3/20/2027
Facility Type Physician Office
Lab Director DR. SCOTT P. BLOOM

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