33D2105021 CLIA NUMBER - MICHELLE GUEVARRA PENA, MD, PLLC

Laboratory Demographics

  • CLIA Code: 33D2105021
  • Facility Name: MICHELLE GUEVARRA PENA, MD, PLLC
  • Facility Address: 14 A JAYNE AVENUE
    PATCHOGUE, NY
    ZIP 11772
  • Facility Phone: 631 475-0222
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MICHELLE GUEVARRA-PENA
  • NPI Number: 1588628911
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 33D2105021
LAB Type Physician Office
Facility Name MICHELLE GUEVARRA PENA, MD, PLLC
Street 14 A JAYNE AVENUE
City PATCHOGUE
State NY
ZIP 11772
Phone 631 475-0222
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. MICHELLE GUEVARRA-PENA

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