33D2181666 CLIA NUMBER - PEDIATRIC WELLNESS SERVICES OF NY DBA FUSION

Laboratory Demographics

  • CLIA Code: 33D2181666
  • Facility Name: PEDIATRIC WELLNESS SERVICES OF NY DBA FUSION
  • Facility Address: 150 MYRTLE AVE PH 3602
    BROOKLYN, NY
    ZIP 11201
  • Facility Phone: 347 401-1112
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. FIDEL G. FERNANDEZ
  • NPI Number: 1346297389
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 33D2181666
LAB Type Physician Office
Facility Name PEDIATRIC WELLNESS SERVICES OF NY DBA FUSION
Street 150 MYRTLE AVE PH 3602
City BROOKLYN
State NY
ZIP 11201
Phone 347 401-1112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2024
Certificate Expiration Date 4/7/2026
Facility Type Physician Office
Lab Director DR. FIDEL G. FERNANDEZ

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