33D0975268 CLIA NUMBER - KUMAR S MANDAL MD

Laboratory Demographics

CLIA Number: 33D0975268

Facility Name: KUMAR S MANDAL MD

Facility Address:
2 CORACI BLVD
SHIRLEY, NY
ZIP 11967
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Facility Phone Number: 631 281-2600

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1689676884

Taxonomy: 207QA0505X - Family Medicine
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

CLIA Record

Field Name	Field Value
CLIA Number	33D0975268
LAB Type	Physician Office
Facility Name	KUMAR S MANDAL MD
Street	2 CORACI BLVD
City	SHIRLEY
State	NY
ZIP	11967
Phone	631 281-2600
CertificateType	4
CertificateEffectiveDate	7/3/2022
CertificateExpirationDate	7/2/2024
FacilityType	Waiver

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