33D2068454 CLIA NUMBER - ADVANCED INTERNAL MEDICINE, PC

Laboratory Demographics

  • CLIA Code: 33D2068454
  • Facility Name: ADVANCED INTERNAL MEDICINE, PC
  • Facility Address: 935 NORTHERN BOULEVARD, SUITE 105
    GREAT NECK, NY
    ZIP 11021
  • Facility Phone: 516 487-0070
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SHAHRAM D. SHAMEKH
  • NPI Number: 1467709451
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D2068454
LAB Type Physician Office
Facility Name ADVANCED INTERNAL MEDICINE, PC
Street 935 NORTHERN BOULEVARD, SUITE 105
City GREAT NECK
State NY
ZIP 11021
Phone 516 487-0070
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Physician Office
Lab Director DR. SHAHRAM D. SHAMEKH

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