33D1107327 CLIA NUMBER - JEROME PEDIATRIC PC

Laboratory Demographics

  • CLIA Code: 33D1107327
  • Facility Name: JEROME PEDIATRIC PC
  • Facility Address: 23 86 JEROME AVENUE
    BRONX, NY
    ZIP 10468
  • Facility Phone: 718 220-1771
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GUIDO R. GIANCARLO
  • NPI Number: 1497078554
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D1107327
LAB Type Physician Office
Facility Name JEROME PEDIATRIC PC
Street 23 86 JEROME AVENUE
City BRONX
State NY
ZIP 10468
Phone 718 220-1771
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/3/2023
Certificate Expiration Date 11/2/2025
Facility Type Physician Office
Lab Director GUIDO R. GIANCARLO

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