33D0878106 CLIA NUMBER - MOHAMMED ISMAIL MD, PC

Laboratory Demographics

  • CLIA Code: 33D0878106
  • Facility Name: MOHAMMED ISMAIL MD, PC
  • Facility Address: 46 THIRD STREET
    WATERFORD, NY
    ZIP 12188
  • Facility Phone: 518 237-0641
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ADILA NATHU
  • NPI Number: 1477588747
  • Taxonomy: 207RA0401X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D0878106
LAB Type Physician Office
Facility Name MOHAMMED ISMAIL MD, PC
Street 46 THIRD STREET
City WATERFORD
State NY
ZIP 12188
Phone 518 237-0641
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2024
Certificate Expiration Date 1/16/2026
Facility Type Physician Office
Lab Director DR. ADILA NATHU

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