33D2192287 CLIA NUMBER - QUEENS BOULEVARD EXTENDED CARE FACILITY DIALYSIS CENTER LLC

Laboratory Demographics

  • CLIA Code: 33D2192287
  • Facility Name: QUEENS BOULEVARD EXTENDED CARE FACILITY DIALYSIS CENTER LLC
  • Facility Address: 61-11 QUEENS BLVD
    WOODSIDE, NY
    ZIP 11377
  • Facility Phone: (718) 205-8822
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. NIMESH A. PATEL
  • NPI Number: 1134767833
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 33D2192287
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name QUEENS BOULEVARD EXTENDED CARE FACILITY DIALYSIS CENTER LLC
Street 61-11 QUEENS BLVD
City WOODSIDE
State NY
ZIP 11377
Phone 7182058822
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2020
Certificate Expiration Date 3/26/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. NIMESH A. PATEL

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This page was last updated on: 5/15/2026