33D0869770 CLIA NUMBER - JOHN R DIMARTINO MD

Laboratory Demographics

  • CLIA Code: 33D0869770
  • Facility Name: JOHN R DIMARTINO MD
  • Facility Address: 747 NORTH BROADWAY, SUITE 1
    MASSAPEQUA, NY
    ZIP 11758
  • Facility Phone: 516 795-5200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JOHN R. DIMARTINO
  • NPI Number: 1104901057
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D0869770
LAB Type Physician Office
Facility Name JOHN R DIMARTINO MD
Street 747 NORTH BROADWAY, SUITE 1
City MASSAPEQUA
State NY
ZIP 11758
Phone 516 795-5200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Physician Office
Lab Director DR. JOHN R. DIMARTINO

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