33D2258059 CLIA NUMBER - ENT AND ALLERGY ASSOCIATES LLP

Laboratory Demographics

CLIA Number: 33D2258059

Facility Name: ENT AND ALLERGY ASSOCIATES LLP

Facility Address:
401 FRANKLIN AVENUE
FRANKLIN SQUARE, NY
ZIP 11010
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Facility Phone Number: 516 355-0505

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124079769

Taxonomy: 207YS0123X - Otolaryngology
An otolaryngologist who specializes in facial plastic surgery.

CLIA Record

Field Name	Field Value
CLIA Number	33D2258059
LAB Type	Physician Office
Facility Name	ENT AND ALLERGY ASSOCIATES LLP
Street	401 FRANKLIN AVENUE
City	FRANKLIN SQUARE
State	NY
ZIP	11010
Phone	516 355-0505
CertificateType	4
CertificateEffectiveDate	4/15/2024
CertificateExpirationDate	4/14/2026
FacilityType	Waiver

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