33D1106328 CLIA NUMBER - INTEGRATED MUSCULOSKELETAL & SPINE GROUP, PLLC

Laboratory Demographics

  • CLIA Code: 33D1106328
  • Facility Name: INTEGRATED MUSCULOSKELETAL & SPINE GROUP, PLLC
  • Facility Address: 111 W OLD COUNTRY RD, SUITE 101
    HICKSVILLE, NY
    ZIP 11801
  • Facility Phone: 516 934-0380
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL NICOLOSI
  • NPI Number: 1083260806
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 33D1106328
LAB Type Physician Office
Facility Name INTEGRATED MUSCULOSKELETAL & SPINE GROUP, PLLC
Street 111 W OLD COUNTRY RD, SUITE 101
City HICKSVILLE
State NY
ZIP 11801
Phone 516 934-0380
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2023
Certificate Expiration Date 10/8/2025
Facility Type Physician Office
Lab Director DR. MICHAEL NICOLOSI

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This page was last updated on: 6/4/2025