33D2053791 CLIA NUMBER - QUEENS BLVD ASC LLC

Laboratory Demographics

  • CLIA Code: 33D2053791
  • Facility Name: QUEENS BLVD ASC LLC
  • Facility Address: 95-25 QUEENS BLVD - 3RD FLOOR
    REGO PARK, NY
    ZIP 11374
  • Facility Phone: 718 406-8000
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. AZEEM KHAN
  • NPI Number: 1891181582
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 33D2053791
LAB Type Ambulatory Surgery Center
Facility Name QUEENS BLVD ASC LLC
Street 95-25 QUEENS BLVD - 3RD FLOOR
City REGO PARK
State NY
ZIP 11374
Phone 718 406-8000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2013
Certificate Expiration Date 3/26/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. AZEEM KHAN

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