33D2287782 CLIA NUMBER - IDCC HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 33D2287782
  • Facility Name: IDCC HEALTH SERVICES
  • Facility Address: 201 KINGS HWY
    BROOKLYN, NY
    ZIP 11223
  • Facility Phone: 718 645-0300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. IRINA PRUCHANSKY
  • NPI Number: 1528447679
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D2287782
LAB Type Physician Office
Facility Name IDCC HEALTH SERVICES
Street 201 KINGS HWY
City BROOKLYN
State NY
ZIP 11223
Phone 718 645-0300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2023
Certificate Expiration Date 3/26/2027
Facility Type Physician Office
Lab Director DR. IRINA PRUCHANSKY

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