33D1074324 CLIA NUMBER - FORTUNE SOCIETY

Laboratory Demographics

  • CLIA Code: 33D1074324
  • Facility Name: FORTUNE SOCIETY
  • Facility Address: 29-76 NORTHERN BLVD
    LONG ISLAND CITY, NY
    ZIP 11101
  • Facility Phone: 212 691-7554
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: DR. TIFFANY A. CUMMINS
  • NPI Number: 1235357237
  • Taxonomy: 101YA0400X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 33D1074324
LAB Type Other
Facility Name FORTUNE SOCIETY
Street 29-76 NORTHERN BLVD
City LONG ISLAND CITY
State NY
ZIP 11101
Phone 212 691-7554
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/26/2007
Certificate Expiration Date 3/26/2027
Facility Type Other
Lab Director DR. TIFFANY A. CUMMINS

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