33D2051318 CLIA NUMBER - PORT JEFFERSON VOLUNTEER AMBULANCE INC

Laboratory Demographics

  • CLIA Code: 33D2051318
  • Facility Name: PORT JEFFERSON VOLUNTEER AMBULANCE INC
  • Facility Address: 25 CRYSTAL BROOK HOLLOW ROAD
    MOUNT SINAI, NY
    ZIP 11766
  • Facility Phone: 631 473-2519
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: DR. CARL GOODMAN
  • NPI Number: 1982923397
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 33D2051318
LAB Type Ambulance
Facility Name PORT JEFFERSON VOLUNTEER AMBULANCE INC
Street 25 CRYSTAL BROOK HOLLOW ROAD
City MOUNT SINAI
State NY
ZIP 11766
Phone 631 473-2519
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2012
Certificate Expiration Date 3/26/2027
Facility Type Ambulance
Lab Director DR. CARL GOODMAN

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