33D2192303 CLIA NUMBER - EAST PATCHOGUE DIALYSIS

Laboratory Demographics

  • CLIA Code: 33D2192303
  • Facility Name: EAST PATCHOGUE DIALYSIS
  • Facility Address: 479 E MAIN ST
    PATCHOGUE, NY
    ZIP 11772
  • Facility Phone: 631 447-2401
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. MOHAMMED S. RAHMAN
  • NPI Number: 1942839378
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D2192303
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name EAST PATCHOGUE DIALYSIS
Street 479 E MAIN ST
City PATCHOGUE
State NY
ZIP 11772
Phone 631 447-2401
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. MOHAMMED S. RAHMAN

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