33D2069243 CLIA NUMBER - OPTUM URGENT CARE PLLC

Laboratory Demographics

  • CLIA Code: 33D2069243
  • Facility Name: OPTUM URGENT CARE PLLC
  • Facility Address: 555 NORTH BROADWAY
    JERICHO, NY
    ZIP 11753
  • Facility Phone: 516 597-5070
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JOHN VILLACCI
  • NPI Number: 1285975797
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D2069243
LAB Type Physician Office
Facility Name OPTUM URGENT CARE PLLC
Street 555 NORTH BROADWAY
City JERICHO
State NY
ZIP 11753
Phone 516 597-5070
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. JOHN VILLACCI

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