33D2235655 CLIA NUMBER - NATASHA COPELIN RN PC VIBRANT REJUVENATION

Laboratory Demographics

  • CLIA Code: 33D2235655
  • Facility Name: NATASHA COPELIN RN PC VIBRANT REJUVENATION
  • Facility Address: 164 COMMACK ROAD STE #6
    COMMACK, NY
    ZIP 11725
  • Facility Phone: 631 486-8566
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. NATASHA L. COPELIN
  • NPI Number: 1699104042
  • Taxonomy: 363LA2200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 33D2235655
LAB Type Physician Office
Facility Name NATASHA COPELIN RN PC VIBRANT REJUVENATION
Street 164 COMMACK ROAD STE #6
City COMMACK
State NY
ZIP 11725
Phone 631 486-8566
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2025
Certificate Expiration Date 9/9/2027
Facility Type Physician Office
Lab Director DR. NATASHA L. COPELIN

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