33D0871412 CLIA NUMBER - MARJORIE J VAN DE STOUWE MD PC

Laboratory Demographics

CLIA Number: 33D0871412

Facility Name: MARJORIE J VAN DE STOUWE MD PC

Facility Address:
30 HEMPSTEAD AVENUE, SUITE 160
ROCKVILLE CENTRE, NY
ZIP 11570
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Facility Phone Number: 516 872-8235

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1962427138

Taxonomy: 207RR0500X - Internal Medicine
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.

CLIA Record

Field Name	Field Value
CLIA Number	33D0871412
LAB Type	Physician Office
Facility Name	MARJORIE J VAN DE STOUWE MD PC
Street	30 HEMPSTEAD AVENUE, SUITE 160
City	ROCKVILLE CENTRE
State	NY
ZIP	11570
Phone	516 872-8235
CertificateType	4
CertificateEffectiveDate	6/2/2023
CertificateExpirationDate	6/1/2025
FacilityType	Waiver

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