33D2236733 CLIA NUMBER - PARK INN HOME

Laboratory Demographics

  • CLIA Code: 33D2236733
  • Facility Name: PARK INN HOME
  • Facility Address: 115-02 OCEAN PROMENADE
    ROCKAWAY PARK, NY
    ZIP 11694
  • Facility Phone: 718 634-3400
  • Facility Type: Other - ADULT HOME
  • Facility Type: Waiver
  • Lab Director: DR. PEYMAN E. YOUNESI
  • NPI Number: 1760190599
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 33D2236733
LAB Type Other - ADULT HOME
Facility Name PARK INN HOME
Street 115-02 OCEAN PROMENADE
City ROCKAWAY PARK
State NY
ZIP 11694
Phone 718 634-3400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2021
Certificate Expiration Date 3/26/2027
Facility Type Other - ADULT HOME
Lab Director DR. PEYMAN E. YOUNESI

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