33D1022925 CLIA NUMBER - CONCOURSE MEDICAL OFFICE PC

Laboratory Demographics

  • CLIA Code: 33D1022925
  • Facility Name: CONCOURSE MEDICAL OFFICE PC
  • Facility Address: 3184 GRAND CONCOURSE, SUITE 2E
    BRONX, NY
    ZIP 10458
  • Facility Phone: 718 220-4380
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RAJI M. AYINLA
  • NPI Number: 1568698132
  • Taxonomy: 207RP1001X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D1022925
LAB Type Physician Office
Facility Name CONCOURSE MEDICAL OFFICE PC
Street 3184 GRAND CONCOURSE, SUITE 2E
City BRONX
State NY
ZIP 10458
Phone 718 220-4380
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2025
Certificate Expiration Date 8/2/2027
Facility Type Physician Office
Lab Director DR. RAJI M. AYINLA

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