33D2104229 CLIA NUMBER - QUEENS MEDICAL PAVILION LLC

Laboratory Demographics

  • CLIA Code: 33D2104229
  • Facility Name: QUEENS MEDICAL PAVILION LLC
  • Facility Address: 69-15 AUSTIN STREET
    FOREST HILLS, NY
    ZIP 11375
  • Facility Phone: (718) 263-3500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL J. WIECHOWSKI
  • NPI Number: 1124384136
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D2104229
LAB Type Physician Office
Facility Name QUEENS MEDICAL PAVILION LLC
Street 69-15 AUSTIN STREET
City FOREST HILLS
State NY
ZIP 11375
Phone 7182633500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2015
Certificate Expiration Date 3/26/2027
Facility Type Physician Office
Lab Director DR. MICHAEL J. WIECHOWSKI

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This page was last updated on: 5/18/2026