33D2255215 CLIA NUMBER - LEILANIE MARTIN FAMILY HEALTH NP

Laboratory Demographics

  • CLIA Code: 33D2255215
  • Facility Name: LEILANIE MARTIN FAMILY HEALTH NP
  • Facility Address: 3640 JOHNSON AVE - PR1A - FRONT OFFICE
    BRONX, NY
    ZIP 10463
  • Facility Phone: 718 790-0904
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: MS. LEILANIE MARTIN
  • NPI Number: 1891177606
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 33D2255215
LAB Type Independent
Facility Name LEILANIE MARTIN FAMILY HEALTH NP
Street 3640 JOHNSON AVE - PR1A - FRONT OFFICE
City BRONX
State NY
ZIP 10463
Phone 718 790-0904
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2022
Certificate Expiration Date 3/26/2027
Facility Type Independent
Lab Director MS. LEILANIE MARTIN

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