BV Port Jefferson Operator LLC
Director
Azmat A Iqbal, M.D.
Expiration Date
Phone Number
(631) 802-5021
UID (Facility ID - Site ID)
H285-0000
Site ID
0000
City
Port Jefferson Sta
CLIA Number
33D2325036
Street Address
1175 Rte 112
State
NY
Zip Code
11776
County
Suffolk
Country
United States
Fax Number
(631) 802-5022
Primary Contact
Megan Sheehan
Contact Phone Number
(631) 802-5021
Certificate Type
WAIVER
Tests
COVID-19 ANTIGEN
Glucose
Facility ID
H285