33D1064684 CLIA NUMBER - HILLSIDE POLYMEDIC DIAGNOSTIC & TREATMENT CENTER

Laboratory Demographics

CLIA Number: 33D1064684

Facility Name: HILLSIDE POLYMEDIC DIAGNOSTIC & TREATMENT CENTER

Facility Address:
187-30 HILLSIDE AVENUE
JAMAICA, NY
ZIP 11432
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Facility Phone Number: 718 264-1111

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1689879280

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	33D1064684
LAB Type	Community Clinic
Facility Name	HILLSIDE POLYMEDIC DIAGNOSTIC & TREATMENT CENTER
Street	187-30 HILLSIDE AVENUE
City	JAMAICA
State	NY
ZIP	11432
Phone	718 264-1111
CertificateType	3
CertificateEffectiveDate	2/12/2007
CertificateExpirationDate	3/26/2027
FacilityType	PPMP

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