Independence Outpatient Treatment Program
Name
Independence Outpatient Treatment Program
Director
Tatiana Gouskova, M.D.
Expiration Date
Phone Number
(718) 402-9000
UID (Facility ID - Site ID)
T758-0013
Site ID
0013
City
Bronx
CLIA Number
33D2054034
Street Address
510 Courtlandt Avenue 5th Floor
State
NY
Zip Code
10451
County
Bronx
Country
United States
Fax Number
(718) 665-0803
Primary Contact
Charles Madray
Contact Phone Number
(718) 402-9000
Certificate Type
WAIVER
Tests
COVID-19 ANTIGEN
Breath Alcohol
Drugs of Abuse
Erythrocyte Sedimentation Rate (ESR)
Glucose
Occult Blood
pH
Pregnancy Test (Urine)
HIV, Rapid
Saliva Alcohol
Strep A Test
Urinalysis
Facility ID
T758