33D1048988 CLIA NUMBER - GOLDMAN DERMATOLOGY, PLLC

Laboratory Demographics

  • CLIA Code: 33D1048988
  • Facility Name: GOLDMAN DERMATOLOGY, PLLC
  • Facility Address: 150 BROADWAY SUITE 1110
    NEW YORK, NY
    ZIP 10038
  • Facility Phone: 212 962-1115
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. TATYANA PETUKHOVA
  • NPI Number: 1154311900
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 33D1048988
LAB Type Physician Office
Facility Name GOLDMAN DERMATOLOGY, PLLC
Street 150 BROADWAY SUITE 1110
City NEW YORK
State NY
ZIP 10038
Phone 212 962-1115
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 1/20/2024
Certificate Expiration Date 1/19/2026
Facility Type Physician Office
Lab Director DR. TATYANA PETUKHOVA

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