33D2068083 CLIA NUMBER - PRIMARY PARTNERCARE PHYSICIANS, PLLC

Laboratory Demographics

  • CLIA Code: 33D2068083
  • Facility Name: PRIMARY PARTNERCARE PHYSICIANS, PLLC
  • Facility Address: 21530 HILLSIDE AVE
    JAMAICA, NY
    ZIP 11427
  • Facility Phone: 718 740-1701
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. EBENEZER K. ODOOM
  • NPI Number: 1942642038
  • Taxonomy: 207RG0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D2068083
LAB Type Physician Office
Facility Name PRIMARY PARTNERCARE PHYSICIANS, PLLC
Street 21530 HILLSIDE AVE
City JAMAICA
State NY
ZIP 11427
Phone 718 740-1701
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Physician Office
Lab Director DR. EBENEZER K. ODOOM

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