33D1088744 CLIA NUMBER - ALLIED PHYSICIANS GROUP PLLC DBA PECONIC PEDIATRIC MEDICINE

Laboratory Demographics

CLIA Number: 33D1088744

Facility Name: ALLIED PHYSICIANS GROUP PLLC DBA PECONIC PEDIATRIC MEDICINE

Facility Address:
34 COMMERCE DRIVE, SUITE 2
RIVERHEAD, NY
ZIP 11901
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Facility Phone Number: 631 722-8880

Facility Type: Physician Office

Certificate Type: Waiver

CLIA Record

Field Name	Field Value
CLIA Number	33D1088744
LAB Type	Physician Office
Facility Name	ALLIED PHYSICIANS GROUP PLLC DBA PECONIC PEDIATRIC MEDICINE
Street	34 COMMERCE DRIVE, SUITE 2
City	RIVERHEAD
State	NY
ZIP	11901
Phone	631 722-8880
CertificateType	4
CertificateEffectiveDate	1/1/2023
CertificateExpirationDate	12/31/2024
FacilityType	Waiver

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