33D2141489 CLIA NUMBER - PORT JEFFERSON ASC LLC

Laboratory Demographics

  • CLIA Code: 33D2141489
  • Facility Name: PORT JEFFERSON ASC LLC
  • Facility Address: 1500 RTE 112 - BLDG 3
    PORT JEFFERSON STATION, NY
    ZIP 11776
  • Facility Phone: 631 828-5555
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. AJAY E. CHITKARA
  • NPI Number: 1881134815
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D2141489
LAB Type Ambulatory Surgery Center
Facility Name PORT JEFFERSON ASC LLC
Street 1500 RTE 112 - BLDG 3
City PORT JEFFERSON STATION
State NY
ZIP 11776
Phone 631 828-5555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2017
Certificate Expiration Date 3/26/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. AJAY E. CHITKARA

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