33D2005734 CLIA NUMBER - SSS FAMILY MEDICINE PC

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Laboratory Demographics

CLIA Number: 33D2005734

Facility Name: SSS FAMILY MEDICINE PC

Facility Address:
115-13A MERRICK BLVD
JAMAICA, NY
ZIP 11434
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Facility Phone Number: 718 558-8998

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1588987234

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2005734
LAB Type	Physician Office
Facility Name	SSS FAMILY MEDICINE PC
Street	115-13A MERRICK BLVD
City	JAMAICA
State	NY
ZIP	11434
Phone	718 558-8998
CertificateType	4
CertificateEffectiveDate	4/2/2024
CertificateExpirationDate	4/1/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024