33D1102361 CLIA NUMBER - PATCHOGUE COMMUNITY CLINIC

Laboratory Demographics

  • CLIA Code: 33D1102361
  • Facility Name: PATCHOGUE COMMUNITY CLINIC
  • Facility Address: 4 PHYLLIS DRIVE
    PATCHOGUE, NY
    ZIP 11772
  • Facility Phone: 631 475-6610
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: TIMOTHY PAL
  • NPI Number: 1598136145
  • Taxonomy: 261QD0000X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 33D1102361
LAB Type Community Clinic
Facility Name PATCHOGUE COMMUNITY CLINIC
Street 4 PHYLLIS DRIVE
City PATCHOGUE
State NY
ZIP 11772
Phone 631 475-6610
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 7/17/2009
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director TIMOTHY PAL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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