33D2209675 CLIA NUMBER - SUFFOLK CARDIOVASCULAR CONSULTANTS PC

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Laboratory Demographics

CLIA Number: 33D2209675

Facility Name: SUFFOLK CARDIOVASCULAR CONSULTANTS PC

Facility Address:
1920 DEER PARK AVE #104
DEER PARK, NY
ZIP 11729
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Facility Phone Number: 631 392-1680

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1588846703

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

CLIA Record

Field Name	Field Value
CLIA Number	33D2209675
LAB Type	Physician Office
Facility Name	SUFFOLK CARDIOVASCULAR CONSULTANTS PC
Street	1920 DEER PARK AVE #104
City	DEER PARK
State	NY
ZIP	11729
Phone	631 392-1680
CertificateType	4
CertificateEffectiveDate	1/15/2023
CertificateExpirationDate	1/14/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024