33D0954126 CLIA NUMBER - SUFFOLK COUNTY CORRECTIONAL FACILITY MAX SECURITY JAIL MEDICAL UNIT

Laboratory Demographics

  • CLIA Code: 33D0954126
  • Facility Name: SUFFOLK COUNTY CORRECTIONAL FACILITY MAX SECURITY JAIL MEDICAL UNIT
  • Facility Address: 100 CENTER DRIVE
    RIVERHEAD, NY
    ZIP 11901
  • Facility Phone: 631 852-1665
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: DR. SHAHEDA A. IFTIKHAR
  • NPI Number: 1598085508
  • Taxonomy: 261QP0905X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D0954126
LAB Type Prison
Facility Name SUFFOLK COUNTY CORRECTIONAL FACILITY MAX SECURITY JAIL MEDICAL UNIT
Street 100 CENTER DRIVE
City RIVERHEAD
State NY
ZIP 11901
Phone 631 852-1665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/2/2017
Certificate Expiration Date 3/26/2027
Facility Type Prison
Lab Director DR. SHAHEDA A. IFTIKHAR

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