33D2066049 CLIA NUMBER - MARIWALLA DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 33D2066049
  • Facility Name: MARIWALLA DERMATOLOGY
  • Facility Address: 1253 MONTAUK HIGHWAY
    WEST ISLIP, NY
    ZIP 11795
  • Facility Phone: 631 665-3376
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. KAVITA MARIWALLA
  • NPI Number: 1891094322
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 33D2066049
LAB Type Physician Office
Facility Name MARIWALLA DERMATOLOGY
Street 1253 MONTAUK HIGHWAY
City WEST ISLIP
State NY
ZIP 11795
Phone 631 665-3376
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/12/2022
Certificate Expiration Date 6/30/2025
Facility Type Physician Office
Lab Director DR. KAVITA MARIWALLA

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This page was last updated on: 6/4/2025