33D2164669 CLIA NUMBER - RENA FERGUSON MD PC

Laboratory Demographics

  • CLIA Code: 33D2164669
  • Facility Name: RENA FERGUSON MD PC
  • Facility Address: 1000 MAIN STREET - SUITE G
    PORT JEFFERSON, NY
    ZIP 11777
  • Facility Phone: 631 760-1830
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RENA FERGUSON
  • NPI Number: 1013082452
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 33D2164669
LAB Type Physician Office
Facility Name RENA FERGUSON MD PC
Street 1000 MAIN STREET - SUITE G
City PORT JEFFERSON
State NY
ZIP 11777
Phone 631 760-1830
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2025
Certificate Expiration Date 4/10/2027
Facility Type Physician Office
Lab Director DR. RENA FERGUSON

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