33D1086970 CLIA NUMBER - MARISSA T SANTOS MD PC

Laboratory Demographics

  • CLIA Code: 33D1086970
  • Facility Name: MARISSA T SANTOS MD PC
  • Facility Address: 69-14 41ST AVENUE, SUITE C 2
    WOODSIDE, NY
    ZIP 11377
  • Facility Phone: 718 478-5600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARISSA T. SANTOS
  • NPI Number: 1659332377
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D1086970
LAB Type Physician Office
Facility Name MARISSA T SANTOS MD PC
Street 69-14 41ST AVENUE, SUITE C 2
City WOODSIDE
State NY
ZIP 11377
Phone 718 478-5600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Physician Office
Lab Director DR. MARISSA T. SANTOS

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