33D1061362 CLIA NUMBER - PRIMARY PARTNERCARE PHYSICIANS PLLC

Laboratory Demographics

  • CLIA Code: 33D1061362
  • Facility Name: PRIMARY PARTNERCARE PHYSICIANS PLLC
  • Facility Address: 150 BROAD HOLLOW ROAD, SUITE 311
    MELVILLE, NY
    ZIP 11747
  • Facility Phone: 631 470-7915
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ARETHA N. PERSAUD-MANCUSI
  • NPI Number: 1942329107
  • Taxonomy: 207QA0505X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D1061362
LAB Type Physician Office
Facility Name PRIMARY PARTNERCARE PHYSICIANS PLLC
Street 150 BROAD HOLLOW ROAD, SUITE 311
City MELVILLE
State NY
ZIP 11747
Phone 631 470-7915
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2024
Certificate Expiration Date 11/15/2026
Facility Type Physician Office
Lab Director ARETHA N. PERSAUD-MANCUSI

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