33D0931734 CLIA NUMBER - JOSIANE LEDERMAN MD PC

Laboratory Demographics

  • CLIA Code: 33D0931734
  • Facility Name: JOSIANE LEDERMAN MD PC
  • Facility Address: 116 LAMBERTS LANE
    STATEN ISLAND, NY
    ZIP 10314
  • Facility Phone: 718 370-0422
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. TATYANA A. PETUKHOVA
  • NPI Number: 1619981511
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 33D0931734
LAB Type Physician Office
Facility Name JOSIANE LEDERMAN MD PC
Street 116 LAMBERTS LANE
City STATEN ISLAND
State NY
ZIP 10314
Phone 718 370-0422
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 2/8/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director DR. TATYANA A. PETUKHOVA

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