33D2289718 CLIA NUMBER - MAGNOLIA MEDICAL PC

Laboratory Demographics

  • CLIA Code: 33D2289718
  • Facility Name: MAGNOLIA MEDICAL PC
  • Facility Address: 11 PARK AVE, SUITE 1K
    MOUNT VERNON, NY
    ZIP 10550
  • Facility Phone: 914 668-6140
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SONAL PATEL
  • NPI Number: 1619657665
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D2289718
LAB Type Physician Office
Facility Name MAGNOLIA MEDICAL PC
Street 11 PARK AVE, SUITE 1K
City MOUNT VERNON
State NY
ZIP 10550
Phone 914 668-6140
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2025
Certificate Expiration Date 9/13/2027
Facility Type Physician Office
Lab Director DR. SONAL PATEL

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