33D2085838 CLIA NUMBER - BENSONHURST URGENT CARE DIVISION OF PROHEALTH URGENT CARE MEDICINE PLLC

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Laboratory Demographics

CLIA Number: 33D2085838

Facility Name: BENSONHURST URGENT CARE DIVISION OF PROHEALTH URGENT CARE MEDICINE PLLC

Facility Address:
6906 18TH AVENUE
BROOKLYN, NY
ZIP 11204
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Facility Phone Number: 718 621-5933

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1801677174

Taxonomy: 372600000X - Adult Companion
An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care.

CLIA Record

Field Name	Field Value
CLIA Number	33D2085838
LAB Type	Physician Office
Facility Name	BENSONHURST URGENT CARE DIVISION OF PROHEALTH URGENT CARE MEDICINE PLLC
Street	6906 18TH AVENUE
City	BROOKLYN
State	NY
ZIP	11204
Phone	718 621-5933
CertificateType	4
CertificateEffectiveDate	9/15/2023
CertificateExpirationDate	9/14/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024