33D2177176 CLIA NUMBER - PGR GASTRO, LLC

Laboratory Demographics

  • CLIA Code: 33D2177176
  • Facility Name: PGR GASTRO, LLC
  • Facility Address: 457 ALTER AVENUE
    STATEN ISLAND, NY
    ZIP 10305
  • Facility Phone: 718 979-9790
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: IMRANA M. ALI
  • NPI Number: 1073106639
  • Taxonomy: 207ZP0102X - Pathology

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CLIA Record

Field Name Field Value
CLIA Number 33D2177176
LAB Type Physician Office
Facility Name PGR GASTRO, LLC
Street 457 ALTER AVENUE
City STATEN ISLAND
State NY
ZIP 10305
Phone 718 979-9790
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 1/7/2020
Certificate Expiration Date 3/26/2027
Facility Type Physician Office
Lab Director IMRANA M. ALI

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