33D2029053 CLIA NUMBER - EXTENDED HOME CARE

Laboratory Demographics

  • CLIA Code: 33D2029053
  • Facility Name: EXTENDED HOME CARE
  • Facility Address: 2003 CONEY ISLAND AVE
    BROOKLYN, NY
    ZIP 11223
  • Facility Phone: 212 356-4200
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: MIKHAIL M. SHPAK
  • NPI Number: 1497261127
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 33D2029053
LAB Type Home Health Agency
Facility Name EXTENDED HOME CARE
Street 2003 CONEY ISLAND AVE
City BROOKLYN
State NY
ZIP 11223
Phone 212 356-4200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2011
Certificate Expiration Date 3/26/2027
Facility Type Home Health Agency
Lab Director MIKHAIL M. SHPAK

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