33D1013662 CLIA NUMBER - PROGRESSIVE SURGERY CENTER

Laboratory Demographics

CLIA Number: 33D1013662

Facility Name: PROGRESSIVE SURGERY CENTER

Facility Address:
340 MEDICAL PLAZA BROAD HOLLOW ROAD
FARMINGDALE, NY
ZIP 11735
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Facility Phone Number: 631 249-3000

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1477645711

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D1013662
LAB Type	Ambulatory Surgery Center
Facility Name	PROGRESSIVE SURGERY CENTER
Street	340 MEDICAL PLAZA BROAD HOLLOW ROAD
City	FARMINGDALE
State	NY
ZIP	11735
Phone	631 249-3000
CertificateType	4
CertificateEffectiveDate	6/13/2003
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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