33D0994505 CLIA NUMBER - SOUTH SHORE MEDICAL CARE PC

Laboratory Demographics

CLIA Number: 33D0994505

Facility Name: SOUTH SHORE MEDICAL CARE PC

Facility Address:
16 VAN COTT ROAD
DEER PARK, NY
ZIP 11729
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Facility Phone Number: 631 274-0777

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1861696171

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	33D0994505
LAB Type	Physician Office
Facility Name	SOUTH SHORE MEDICAL CARE PC
Street	16 VAN COTT ROAD
City	DEER PARK
State	NY
ZIP	11729
Phone	631 274-0777
CertificateType	4
CertificateEffectiveDate	12/24/2023
CertificateExpirationDate	12/23/2025
FacilityType	Waiver

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