33D2020630 CLIA NUMBER - TIMOTHY D GROTH MD PC

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Laboratory Demographics

CLIA Number: 33D2020630

Facility Name: TIMOTHY D GROTH MD PC

Facility Address:
994 WEST JERICHO TURNPIKE STE 104
SMITHTOWN, NY
ZIP 11787
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Facility Phone Number: 631 543-1440

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1093742272

Taxonomy: 207LP2900X - Anesthesiology
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

CLIA Record

Field Name	Field Value
CLIA Number	33D2020630
LAB Type	Physician Office
Facility Name	TIMOTHY D GROTH MD PC
Street	994 WEST JERICHO TURNPIKE STE 104
City	SMITHTOWN
State	NY
ZIP	11787
Phone	631 543-1440
CertificateType	4
CertificateEffectiveDate	2/24/2023
CertificateExpirationDate	2/23/2025
FacilityType	Waiver

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