33D0908039 CLIA NUMBER - TERRACE MEDICAL, PC

Laboratory Demographics

CLIA Number: 33D0908039

Facility Name: TERRACE MEDICAL, PC

Facility Address:
214-06 16TH AVENUE
BAYSIDE, NY
ZIP 11360
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Facility Phone Number: 718 224-3734

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1588850911

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

CLIA Record

Field Name	Field Value
CLIA Number	33D0908039
LAB Type	Physician Office
Facility Name	TERRACE MEDICAL, PC
Street	214-06 16TH AVENUE
City	BAYSIDE
State	NY
ZIP	11360
Phone	718 224-3734
CertificateType	4
CertificateEffectiveDate	3/7/2024
CertificateExpirationDate	3/6/2026
FacilityType	Waiver

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