33D0968471 CLIA NUMBER - GRAND MEDICAL PLLC

Laboratory Demographics

  • CLIA Code: 33D0968471
  • Facility Name: GRAND MEDICAL PLLC
  • Facility Address: 2280 GRAND AVE #303
    BALDWIN, NY
    ZIP 11510
  • Facility Phone: 516 771-2758
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SONYA S. VENTOUR
  • NPI Number: 1023288149
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D0968471
LAB Type Physician Office
Facility Name GRAND MEDICAL PLLC
Street 2280 GRAND AVE #303
City BALDWIN
State NY
ZIP 11510
Phone 516 771-2758
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/13/2023
Certificate Expiration Date 12/12/2025
Facility Type Physician Office
Lab Director SONYA S. VENTOUR

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