33D1028973 CLIA NUMBER - QUEENS VILLAGE DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 33D1028973
  • Facility Name: QUEENS VILLAGE DIALYSIS CENTER
  • Facility Address: 22202 HEMPSTEAD AVE - SUITE 170
    QUEENS VILLAGE, NY
    ZIP 11429
  • Facility Phone: 718 217-6200
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. LIONEL E. DESROCHES
  • NPI Number: 1770528432
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D1028973
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name QUEENS VILLAGE DIALYSIS CENTER
Street 22202 HEMPSTEAD AVE - SUITE 170
City QUEENS VILLAGE
State NY
ZIP 11429
Phone 718 217-6200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2006
Certificate Expiration Date 3/26/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. LIONEL E. DESROCHES

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