33D2325036 CLIA NUMBER - BV PORT JEFFERSON OPERATOR LLC

Laboratory Demographics

  • CLIA Code: 33D2325036
  • Facility Name: BV PORT JEFFERSON OPERATOR LLC
  • Facility Address: 1175 RTE 112
    PORT JEFFERSON STATION, NY
    ZIP 11776
  • Facility Phone: 631 802-5021
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DR. AZMAT A. IQBAL
  • NPI Number: 1649931254
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 33D2325036
LAB Type Assisted Living Facility
Facility Name BV PORT JEFFERSON OPERATOR LLC
Street 1175 RTE 112
City PORT JEFFERSON STATION
State NY
ZIP 11776
Phone 631 802-5021
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2025
Certificate Expiration Date 3/26/2027
Facility Type Assisted Living Facility
Lab Director DR. AZMAT A. IQBAL

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