33D2017647 CLIA NUMBER - PM PEDIATRICS OF BAYSIDE PLLC

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Laboratory Demographics

CLIA Number: 33D2017647

Facility Name: PM PEDIATRICS OF BAYSIDE PLLC

Facility Address:
210-31 26TH AVENUE
BAYSIDE, NY
ZIP 11360
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Facility Phone Number: 718 747-5437

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1861700353

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	33D2017647
LAB Type	Physician Office
Facility Name	PM PEDIATRICS OF BAYSIDE PLLC
Street	210-31 26TH AVENUE
City	BAYSIDE
State	NY
ZIP	11360
Phone	718 747-5437
CertificateType	4
CertificateEffectiveDate	4/1/2023
CertificateExpirationDate	3/31/2025
FacilityType	Waiver

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