33D2326830 CLIA NUMBER - SUSALUD MEDICAL PC

Laboratory Demographics

  • CLIA Code: 33D2326830
  • Facility Name: SUSALUD MEDICAL PC
  • Facility Address: 1855 MOTT AVE
    FAR ROCKAWAY, NY
    ZIP 11691
  • Facility Phone: 718 868-8282
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ANNETA C. RAMCHARRAN
  • NPI Number: 1043844905
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D2326830
LAB Type Practitioner Other
Facility Name SUSALUD MEDICAL PC
Street 1855 MOTT AVE
City FAR ROCKAWAY
State NY
ZIP 11691
Phone 718 868-8282
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2025
Certificate Expiration Date 3/26/2027
Facility Type Practitioner Other
Lab Director ANNETA C. RAMCHARRAN

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