33D1070793 CLIA NUMBER - MARILYN M JACKSON MD MPH PLLC

Laboratory Demographics

  • CLIA Code: 33D1070793
  • Facility Name: MARILYN M JACKSON MD MPH PLLC
  • Facility Address: 421 WEST 57TH STREET STE B
    NEW YORK, NY
    ZIP 10019
  • Facility Phone: (212) 247-8023
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARILYN M. JACKSON
  • NPI Number: 1811097744
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D1070793
LAB Type Physician Office
Facility Name MARILYN M JACKSON MD MPH PLLC
Street 421 WEST 57TH STREET STE B
City NEW YORK
State NY
ZIP 10019
Phone 2122478023
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2025
Certificate Expiration Date 7/9/2027
Facility Type Physician Office
Lab Director MARILYN M. JACKSON

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This page was last updated on: 5/18/2026