33D2124839 CLIA NUMBER - OPTUM MEDICAL PC PEDIATRIC OPHTHALMOLOGY OF GREATER NY

Laboratory Demographics

CLIA Number: 33D2124839

Facility Name: OPTUM MEDICAL PC PEDIATRIC OPHTHALMOLOGY OF GREATER NY

Facility Address:
1000 NORTHERN BOULEVARD - STE 190
GREAT NECK, NY
ZIP 11021
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Facility Phone Number: 516 487-0410

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1760685481

Taxonomy: 207W00000X - Ophthalmology
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

CLIA Record

Field Name	Field Value
CLIA Number	33D2124839
LAB Type	Physician Office
Facility Name	OPTUM MEDICAL PC PEDIATRIC OPHTHALMOLOGY OF GREATER NY
Street	1000 NORTHERN BOULEVARD - STE 190
City	GREAT NECK
State	NY
ZIP	11021
Phone	516 487-0410
CertificateType	4
CertificateEffectiveDate	1/26/2023
CertificateExpirationDate	1/25/2025
FacilityType	Waiver

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