33D2219238 CLIA NUMBER - PECONIC BAY DIALYSIS

Laboratory Demographics

  • CLIA Code: 33D2219238
  • Facility Name: PECONIC BAY DIALYSIS
  • Facility Address: 700 OLD COUNTRY RD, SUITE 4
    RIVERHEAD, NY
    ZIP 11901
  • Facility Phone: 631 208-0282
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: NEERU KUMAR
  • NPI Number: 1841683281
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 33D2219238
LAB Type Comp. Outpatient Rehab Facility
Facility Name PECONIC BAY DIALYSIS
Street 700 OLD COUNTRY RD, SUITE 4
City RIVERHEAD
State NY
ZIP 11901
Phone 631 208-0282
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2021
Certificate Expiration Date 3/26/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director NEERU KUMAR

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