33D2164015 CLIA NUMBER - MANHATTAN DERMATOLOGY & COSMETIC SURGERY PLLC

Laboratory Demographics

  • CLIA Code: 33D2164015
  • Facility Name: MANHATTAN DERMATOLOGY & COSMETIC SURGERY PLLC
  • Facility Address: 125 EAST 63RD STREET - UNIT 1BC
    NEW YORK, NY
    ZIP 10065
  • Facility Phone: 212 661-4784
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. MICHAEL TASSAVOR
  • NPI Number: 1396376893
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 33D2164015
LAB Type Physician Office
Facility Name MANHATTAN DERMATOLOGY & COSMETIC SURGERY PLLC
Street 125 EAST 63RD STREET - UNIT 1BC
City NEW YORK
State NY
ZIP 10065
Phone 212 661-4784
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 11/7/2021
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director DR. MICHAEL TASSAVOR

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