33D2105004 CLIA NUMBER - RICHARD E YOUNG AND ARLENE L VAZQUEZ-YOUNG, OD PC DBA MAIN STREET OPTOMETRY

Laboratory Demographics

  • CLIA Code: 33D2105004
  • Facility Name: RICHARD E YOUNG AND ARLENE L VAZQUEZ-YOUNG, OD PC DBA MAIN STREET OPTOMETRY
  • Facility Address: 89 MAIN STREET
    NORTHPORT, NY
    ZIP 11768
  • Facility Phone: 631 757-6190
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RICHARD E. YOUNG
  • NPI Number: 1619043601
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 33D2105004
LAB Type Physician Office
Facility Name RICHARD E YOUNG AND ARLENE L VAZQUEZ-YOUNG, OD PC DBA MAIN STREET OPTOMETRY
Street 89 MAIN STREET
City NORTHPORT
State NY
ZIP 11768
Phone 631 757-6190
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Physician Office
Lab Director DR. RICHARD E. YOUNG

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