33D1015633 CLIA NUMBER - STATEN ISLAND CBOC

Laboratory Demographics

  • CLIA Code: 33D1015633
  • Facility Name: STATEN ISLAND CBOC
  • Facility Address: SOUTHPORT PLAZA 1150 SOUTH AVENUE
    STATEN ISLAND, NY
    ZIP 10314
  • Facility Phone: 718 761-2973
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: PENG LEE
  • NPI Number: 1942799366
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 33D1015633
LAB Type Community Clinic
Facility Name STATEN ISLAND CBOC
Street SOUTHPORT PLAZA 1150 SOUTH AVENUE
City STATEN ISLAND
State NY
ZIP 10314
Phone 718 761-2973
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 8/11/2003
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director PENG LEE

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