33D2170203 CLIA NUMBER - MEDICAL DIAGNOSTIC IMAGING, PLLC

Laboratory Demographics

  • CLIA Code: 33D2170203
  • Facility Name: MEDICAL DIAGNOSTIC IMAGING, PLLC
  • Facility Address: 1323 ROUTE 9 SUITE 107
    WAPPINGERS FALLS, NY
    ZIP 12590
  • Facility Phone: 845 297-5439
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. GARY D. GROSSMAN
  • NPI Number: 1023435971
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D2170203
LAB Type Physician Office
Facility Name MEDICAL DIAGNOSTIC IMAGING, PLLC
Street 1323 ROUTE 9 SUITE 107
City WAPPINGERS FALLS
State NY
ZIP 12590
Phone 845 297-5439
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2025
Certificate Expiration Date 8/5/2027
Facility Type Physician Office
Lab Director DR. GARY D. GROSSMAN

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