33D1057473 CLIA NUMBER - OPTIMUM FAMILY MEDICINE PC

Laboratory Demographics

CLIA Number: 33D1057473

Facility Name: OPTIMUM FAMILY MEDICINE PC

Facility Address:
675 NEREID AVENUE
BRONX, NY
ZIP 10470
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Facility Phone Number: 646 441-1399

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1609952043

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	33D1057473
LAB Type	Physician Office
Facility Name	OPTIMUM FAMILY MEDICINE PC
Street	675 NEREID AVENUE
City	BRONX
State	NY
ZIP	10470
Phone	646 441-1399
CertificateType	4
CertificateEffectiveDate	8/14/2022
CertificateExpirationDate	8/13/2024
FacilityType	Waiver

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