33D1003791 CLIA NUMBER - PARK NURSING HOME

Laboratory Demographics

  • CLIA Code: 33D1003791
  • Facility Name: PARK NURSING HOME
  • Facility Address: 128 BEACH 115 STREET
    ROCKAWAY PARK, NY
    ZIP 11694
  • Facility Phone: 718 474-6400
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. ISAAC R. MADEB
  • NPI Number: 1801887898
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 33D1003791
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PARK NURSING HOME
Street 128 BEACH 115 STREET
City ROCKAWAY PARK
State NY
ZIP 11694
Phone 718 474-6400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2002
Certificate Expiration Date 3/26/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. ISAAC R. MADEB

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