33D2218648 CLIA NUMBER - BLUE SPECTRUM FAMILY HEALTH NP PLLC

Laboratory Demographics

CLIA Number: 33D2218648

Facility Name: BLUE SPECTRUM FAMILY HEALTH NP PLLC

Facility Address:
1218 NEPTUNE AVE
BROOKLYN, NY
ZIP 11224
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Facility Phone Number: 718 200-8094

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1194326983

Taxonomy: 363LP2300X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	33D2218648
LAB Type	Physician Office
Facility Name	BLUE SPECTRUM FAMILY HEALTH NP PLLC
Street	1218 NEPTUNE AVE
City	BROOKLYN
State	NY
ZIP	11224
Phone	718 200-8094
CertificateType	4
CertificateEffectiveDate	3/30/2023
CertificateExpirationDate	3/29/2025
FacilityType	Waiver

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