33D2114386 CLIA NUMBER - LONG ISLAND COMMUNITY HOSPITAL WOUND CARE

Laboratory Demographics

CLIA Number: 33D2114386

Facility Name: LONG ISLAND COMMUNITY HOSPITAL WOUND CARE

Facility Address:
300 KENNEDY DRIVE
HAUPPAUGE, NY
ZIP 11788
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Facility Phone Number: 631 227-6650

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Waiver

NPI Number: 1275847568

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	33D2114386
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	LONG ISLAND COMMUNITY HOSPITAL WOUND CARE
Street	300 KENNEDY DRIVE
City	HAUPPAUGE
State	NY
ZIP	11788
Phone	631 227-6650
CertificateType	4
CertificateEffectiveDate	6/13/2016
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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