33D2177308 CLIA NUMBER - SUPREME DIAGNOSTICS

Laboratory Demographics

  • CLIA Code: 33D2177308
  • Facility Name: SUPREME DIAGNOSTICS
  • Facility Address: 4510 16TH AVENUE, 3RD FLOOR
    BROOKLYN, NY
    ZIP 11204
  • Facility Phone: 718 964-3306
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: AYAD MUDARRIS
  • NPI Number: 1316597958
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 33D2177308
LAB Type Independent
Facility Name SUPREME DIAGNOSTICS
Street 4510 16TH AVENUE, 3RD FLOOR
City BROOKLYN
State NY
ZIP 11204
Phone 718 964-3306
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 1/8/2020
Certificate Expiration Date 3/26/2027
Facility Type Independent
Lab Director AYAD MUDARRIS

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