33D1098074 CLIA NUMBER - JACKSON HEIGHTS WOMEN'S GYNECOLOGICAL PC

Laboratory Demographics

  • CLIA Code: 33D1098074
  • Facility Name: JACKSON HEIGHTS WOMEN'S GYNECOLOGICAL PC
  • Facility Address: 78-13 ROOSEVELT AVENUE 2ND FLOOR
    JACKSON HEIGHTS, NY
    ZIP 11372
  • Facility Phone: 718 205-0234
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DAVID A. GLUCK
  • NPI Number: 1427691088
  • Taxonomy: 207RE0101X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D1098074
LAB Type Physician Office
Facility Name JACKSON HEIGHTS WOMEN'S GYNECOLOGICAL PC
Street 78-13 ROOSEVELT AVENUE 2ND FLOOR
City JACKSON HEIGHTS
State NY
ZIP 11372
Phone 718 205-0234
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2025
Certificate Expiration Date 4/9/2027
Facility Type Physician Office
Lab Director DR. DAVID A. GLUCK

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