33D0874512 CLIA NUMBER - JOSE QUIWA MD

Laboratory Demographics

CLIA Number: 33D0874512

Facility Name: JOSE QUIWA MD

Facility Address:
85-02 66TH ROAD
REGO PARK, NY
ZIP 11374
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Facility Phone Number: 718 426-5202

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1306816103

Taxonomy: 2080A0000X - Pediatrics
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

CLIA Record

Field Name	Field Value
CLIA Number	33D0874512
LAB Type	Physician Office
Facility Name	JOSE QUIWA MD
Street	85-02 66TH ROAD
City	REGO PARK
State	NY
ZIP	11374
Phone	718 426-5202
CertificateType	4
CertificateEffectiveDate	8/11/2023
CertificateExpirationDate	8/10/2025
FacilityType	Waiver

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