33D1027099 CLIA NUMBER - ADOLESCENT-YOUNG ADULT MEDICINE OF GREAT NECK LLC

Laboratory Demographics

  • CLIA Code: 33D1027099
  • Facility Name: ADOLESCENT-YOUNG ADULT MEDICINE OF GREAT NECK LLC
  • Facility Address: 29 BARSTOW ROAD, SUITE 201
    GREAT NECK, NY
    ZIP 11021
  • Facility Phone: 516 482-5400
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JONATHAN D. TRAGER

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CLIA Record

Field Name Field Value
CLIA Number 33D1027099
LAB Type Physician Office
Facility Name ADOLESCENT-YOUNG ADULT MEDICINE OF GREAT NECK LLC
Street 29 BARSTOW ROAD, SUITE 201
City GREAT NECK
State NY
ZIP 11021
Phone 516 482-5400
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/23/2024
Certificate Expiration Date 6/22/2026
Facility Type Physician Office
Lab Director DR. JONATHAN D. TRAGER

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This page was last updated on: 3/20/2025