33D0952765 CLIA NUMBER - BRUNO MANDUCA MD

Laboratory Demographics

  • CLIA Code: 33D0952765
  • Facility Name: BRUNO MANDUCA MD
  • Facility Address: 184 HOLDEN BLVD
    STATEN ISLAND, NY
    ZIP 10314
  • Facility Phone: 718 815-0710
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRUNO MANDUCA
  • NPI Number: 1790718013
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D0952765
LAB Type Physician Office
Facility Name BRUNO MANDUCA MD
Street 184 HOLDEN BLVD
City STATEN ISLAND
State NY
ZIP 10314
Phone 718 815-0710
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2024
Certificate Expiration Date 10/19/2026
Facility Type Physician Office
Lab Director BRUNO MANDUCA

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