33D1095218 CLIA NUMBER - SEONGPAN PHYSICIAN PC

Laboratory Demographics

  • CLIA Code: 33D1095218
  • Facility Name: SEONGPAN PHYSICIAN PC
  • Facility Address: 758 56TH STREET, 1F
    BROOKLYN, NY
    ZIP 11220
  • Facility Phone: 718 436-3023
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SEONGPAN SI, MD
  • NPI Number: 1164422838
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 33D1095218
LAB Type Physician Office
Facility Name SEONGPAN PHYSICIAN PC
Street 758 56TH STREET, 1F
City BROOKLYN
State NY
ZIP 11220
Phone 718 436-3023
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Physician Office
Lab Director SEONGPAN SI, MD

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