33D2094463 CLIA NUMBER - OPTUM MEDICAL PC COMPREHENSIVE ALLERGY AND ASTHMA

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Laboratory Demographics

CLIA Number: 33D2094463

Facility Name: OPTUM MEDICAL PC COMPREHENSIVE ALLERGY AND ASTHMA

Facility Address:
2209 MERRICK ROAD, SUITE 202
MERRICK, NY
ZIP 11566
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Facility Phone Number: 516 771-4800

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1407088255

Taxonomy: 207K00000X - Allergy & Immunology
An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system.

CLIA Record

Field Name	Field Value
CLIA Number	33D2094463
LAB Type	Physician Office
Facility Name	OPTUM MEDICAL PC COMPREHENSIVE ALLERGY AND ASTHMA
Street	2209 MERRICK ROAD, SUITE 202
City	MERRICK
State	NY
ZIP	11566
Phone	516 771-4800
CertificateType	4
CertificateEffectiveDate	4/17/2023
CertificateExpirationDate	4/16/2025
FacilityType	Waiver

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