33D2059052 CLIA NUMBER - DOCTOR MARK PHYSICIAN, PC DBA PRECISION DIAGNOSTICS

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Laboratory Demographics

CLIA Number: 33D2059052

Facility Name: DOCTOR MARK PHYSICIAN, PC DBA PRECISION DIAGNOSTICS

Facility Address:
1502 EAST 14TH STREET, SUITE 2
BROOKLYN, NY
ZIP 11230
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Facility Phone Number: 347 541-6251

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1164846085

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	33D2059052
LAB Type	Physician Office
Facility Name	DOCTOR MARK PHYSICIAN, PC DBA PRECISION DIAGNOSTICS
Street	1502 EAST 14TH STREET, SUITE 2
City	BROOKLYN
State	NY
ZIP	11230
Phone	347 541-6251
CertificateType	4
CertificateEffectiveDate	10/24/2022
CertificateExpirationDate	10/23/2024
FacilityType	Waiver

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