33D2043778 CLIA NUMBER - NEW YORK GLAUCOMA MEDICAL PC

Laboratory Demographics

  • CLIA Code: 33D2043778
  • Facility Name: NEW YORK GLAUCOMA MEDICAL PC
  • Facility Address: 103 QUENTIN ROAD, SUITE G1-1
    BROOKLYN, NY
    ZIP 11223
  • Facility Phone: (718) 645-2201
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. IRINA PANKOVA
  • NPI Number: 1013020296
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 33D2043778
LAB Type Physician Office
Facility Name NEW YORK GLAUCOMA MEDICAL PC
Street 103 QUENTIN ROAD, SUITE G1-1
City BROOKLYN
State NY
ZIP 11223
Phone 7186452201
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2024
Certificate Expiration Date 7/9/2026
Facility Type Physician Office
Lab Director DR. IRINA PANKOVA

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This page was last updated on: 5/15/2026