33D2108443 CLIA NUMBER - WYCKOFF DOCTOR

Laboratory Demographics

  • CLIA Code: 33D2108443
  • Facility Name: WYCKOFF DOCTOR
  • Facility Address: 1419 MYRTLE AVE
    BROOKLYN, NY
    ZIP 11237
  • Facility Phone: 718 963-7676
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: DR. WILHELMINA P. CRUZ-VETRANO
  • NPI Number: 1811347404
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D2108443
LAB Type Ancillary Testing Site in Health Care Center
Facility Name WYCKOFF DOCTOR
Street 1419 MYRTLE AVE
City BROOKLYN
State NY
ZIP 11237
Phone 718 963-7676
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2016
Certificate Expiration Date 3/26/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director DR. WILHELMINA P. CRUZ-VETRANO

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