33D0957390 CLIA NUMBER - LONG ISLAND AMBULATORY SURGERY CENTER

Laboratory Demographics

  • Code: 33D0957390
  • Facility Name: LONG ISLAND AMBULATORY SURGERY CENTER
  • Facility Address: 601 SUFFOLK AVE, 2ND FLOOR
    BRENTWOOD, NY
    ZIP 11717
  • Facility Phone: 631 231-4949
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • NPI Number: 1518057546
  • Taxonomy: 261QA1903X - Clinic/Center
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CLIA Record

Field Name Field Value
CLIA Number 33D0957390
LAB Type Ambulatory Surgery Center
Facility Name LONG ISLAND AMBULATORY SURGERY CENTER
Street 601 SUFFOLK AVE, 2ND FLOOR
City BRENTWOOD
State NY
ZIP 11717
Phone 631 231-4949
Certificate Type 4
Certificate Effective Date 2/19/1999
Certificate Expiration Date 3/26/2027
Facility Type Waiver

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