33D2065419 CLIA NUMBER - BROADWAY INTERNAL MEDICINE PC

Laboratory Demographics

  • CLIA Code: 33D2065419
  • Facility Name: BROADWAY INTERNAL MEDICINE PC
  • Facility Address: 41-07 76TH STREET
    ELMHURST, NY
    ZIP 11373
  • Facility Phone: (718) 803-3201
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CARLOS M. GONZALEZ
  • NPI Number: 1124265848
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D2065419
LAB Type Physician Office
Facility Name BROADWAY INTERNAL MEDICINE PC
Street 41-07 76TH STREET
City ELMHURST
State NY
ZIP 11373
Phone 7188033201
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2025
Certificate Expiration Date 9/8/2027
Facility Type Physician Office
Lab Director DR. CARLOS M. GONZALEZ

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This page was last updated on: 5/18/2026