33D1021077 CLIA NUMBER - MICHAEL G MARCUS, MD

Laboratory Demographics

  • CLIA Code: 33D1021077
  • Facility Name: MICHAEL G MARCUS, MD
  • Facility Address: 105 BENTON AVENUE
    STATEN ISLAND, NY
    ZIP 10305
  • Facility Phone: 718 980-5864
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL G. MARCUS
  • NPI Number: 1962084343
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 33D1021077
LAB Type Physician Office
Facility Name MICHAEL G MARCUS, MD
Street 105 BENTON AVENUE
City STATEN ISLAND
State NY
ZIP 10305
Phone 718 980-5864
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2023
Certificate Expiration Date 10/19/2025
Facility Type Physician Office
Lab Director DR. MICHAEL G. MARCUS

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