33D2293496 CLIA NUMBER - NORTHEAST MEDICAL PRACTICE PC

Laboratory Demographics

  • CLIA Code: 33D2293496
  • Facility Name: NORTHEAST MEDICAL PRACTICE PC
  • Facility Address: 17 MAPLE DRIVE, SUITE 5
    GREAT NECK, NY
    ZIP 11021
  • Facility Phone: 516 604-3418
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. WILLIAM A. BERGER
  • NPI Number: 1700571353
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D2293496
LAB Type Physician Office
Facility Name NORTHEAST MEDICAL PRACTICE PC
Street 17 MAPLE DRIVE, SUITE 5
City GREAT NECK
State NY
ZIP 11021
Phone 516 604-3418
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2023
Certificate Expiration Date 11/8/2025
Facility Type Physician Office
Lab Director DR. WILLIAM A. BERGER

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