33D1100954 CLIA NUMBER - SETAUKET PRIMARY MEDICAL CARE

Laboratory Demographics

  • CLIA Code: 33D1100954
  • Facility Name: SETAUKET PRIMARY MEDICAL CARE
  • Facility Address: 200 MAIN STREET, SUITE 5
    SETAUKET, NY
    ZIP 11733
  • Facility Phone: 631 331-3400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. TANYA ROTH-ADAMS
  • NPI Number: 1245695436
  • Taxonomy: 171100000X - Acupuncturist

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CLIA Record

Field Name Field Value
CLIA Number 33D1100954
LAB Type Physician Office
Facility Name SETAUKET PRIMARY MEDICAL CARE
Street 200 MAIN STREET, SUITE 5
City SETAUKET
State NY
ZIP 11733
Phone 631 331-3400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Physician Office
Lab Director DR. TANYA ROTH-ADAMS

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