33D1095777 CLIA NUMBER - OLUSEGUN M ADEONIGBAGBE MD PC

Laboratory Demographics

  • CLIA Code: 33D1095777
  • Facility Name: OLUSEGUN M ADEONIGBAGBE MD PC
  • Facility Address: 19203 JAMAICA AVE
    HOLLIS, NY
    ZIP 11423
  • Facility Phone: 718 217-7744
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OLUSEGUN M. ADEONIGBAGBE,MD
  • NPI Number: 1073570081
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D1095777
LAB Type Physician Office
Facility Name OLUSEGUN M ADEONIGBAGBE MD PC
Street 19203 JAMAICA AVE
City HOLLIS
State NY
ZIP 11423
Phone 718 217-7744
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/18/2025
Certificate Expiration Date 2/17/2027
Facility Type Physician Office
Lab Director OLUSEGUN M. ADEONIGBAGBE,MD

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