33D0963321 CLIA NUMBER - INTERMED CARE PC

Laboratory Demographics

  • CLIA Code: 33D0963321
  • Facility Name: INTERMED CARE PC
  • Facility Address: 3048 BRIGHTON 1ST FLOOR
    BROOKLYN, NY
    ZIP 11235
  • Facility Phone: 718 331-9600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MIKHAIL S. TETROK
  • NPI Number: 1063792158
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D0963321
LAB Type Physician Office
Facility Name INTERMED CARE PC
Street 3048 BRIGHTON 1ST FLOOR
City BROOKLYN
State NY
ZIP 11235
Phone 718 331-9600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2024
Certificate Expiration Date 11/15/2026
Facility Type Physician Office
Lab Director MIKHAIL S. TETROK

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