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33D1052635 CLIA NUMBER - AESTHETIC PLASTIC SURGERY PC

Laboratory Demographics

CLIA Number: 33D1052635

Facility Name: AESTHETIC PLASTIC SURGERY PC

Facility Address:
833 NORTHERN BLVD - SUITE 160
GREAT NECK, NY
ZIP 11021
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Facility Phone Number: 516 498-8400

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver
NPI Number: 1114191905

Taxonomy: 2086S0122X - Surgery
A surgeon who specializes in plastic and reconstructive surgery.

CLIA Record

Field Name Field Value
CLIA Number 33D1052635
LAB Type Ambulatory Surgery Center
Facility Name AESTHETIC PLASTIC SURGERY PC
Street 833 NORTHERN BLVD - SUITE 160
City GREAT NECK
State NY
ZIP 11021
Phone 516 498-8400
CertificateType 4
CertificateEffectiveDate 3/30/2006
CertificateExpirationDate 3/26/2027
FacilityType Waiver

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This page was last updated on: 4/23/2024