33D0947794 CLIA NUMBER - OPTUM MEDICAL CARE PC

Laboratory Demographics

  • CLIA Code: 33D0947794
  • Facility Name: OPTUM MEDICAL CARE PC
  • Facility Address: 575 UNDERHILL BLVD - STE 200 & 210
    SYOSSET, NY
    ZIP 11791
  • Facility Phone: 516 822-4404
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. PAUL R. PERVIL
  • NPI Number: 1275312977
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 33D0947794
LAB Type Physician Office
Facility Name OPTUM MEDICAL CARE PC
Street 575 UNDERHILL BLVD - STE 200 & 210
City SYOSSET
State NY
ZIP 11791
Phone 516 822-4404
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2023
Certificate Expiration Date 12/5/2025
Facility Type Physician Office
Lab Director DR. PAUL R. PERVIL

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