NHPP Gastroenterology of Lake Success
PFI: T751
Secondary Site ID: 0001
Certification Type: WAIVER
Director: Rubina S. Cocker, M.D.
Phone: (516) 775-7770
Fax: (516) 775-8080
Address: 2001 Marcus Ave - Suite N18, Lake Success, NY 11042
County: Nassau
Country: United States
Single or Primary Contact: Christopher Young
Contact Phone: (516) 416-6220
CLIA #: 33D2052475
Tests:
COVID-19 ANTIGEN Community Screening Glucose Glycosylated Hemoglobin Influenza Occult Blood Protime Pregnancy Test (Urine) COVID-19 MOLECULAR HCV, Rapid HIV, Rapid RSV (Respiratory Syncytial Virus) Strep A Test Syphilis Antibodies Urinalysis
01/11/2027
Northwell Health Physician Partners Medicine Specialties at Great Neck
PFI: T752
Secondary Site ID: 0000
Certification Type: WAIVER
Director: Rubina S. Cocker, M.D.
Phone: (516) 482-0600
Fax: (516) 829-9674
Address: 560 Northern Blvd - Suite 203, Great Neck, NY 11021
County: Nassau
Country: United States
Single or Primary Contact: Christopher Young
Contact Phone: (516) 416-6220
CLIA #: 33D2052479
Tests:
Glucose Glycosylated Hemoglobin Hemoglobin Influenza Ketones Protime Pregnancy Test (Urine) Strep A Test Urinalysis
01/11/2027
Port Jefferson Volunteer Ambulance Inc
PFI: T754
Secondary Site ID: 0000
Certification Type: WAIVER
Director: Carl S Goodman, D.O.
Phone: (631) 473-2519
Fax: (631) 476-6716
Address: 25 Crystal Brook Hollow Road, Mount Sinai, NY 11766
County: Suffolk
Country: United States
Single or Primary Contact: Michael Presta
Contact Phone: (631) 473-2519
CLIA #: 33D2051318
Tests:
COVID-19 ANTIGEN Adenovirus Blood Urea Nitrogen (BUN) Bordetella parapertussis Bordetella pertussis Carbon Dioxide Chloride Chlamydophila pneumoniae Community Screening Coronavirus Creatinine Creatine Kinase (CK) Drugs of Abuse Glucose Hemoglobin Hematocrit Human Metapneumovirus Human Rhinovirus/Enterovirus Influenza Lactic Acid (Lactate) Mycoplasma pneumoniae Parainfluenza Virus Potassium COVID-19 MOLECULAR RSV (Respiratory Syncytial Virus) Saliva Alcohol COVID-19 ANTIBODY Sodium
12/18/2025
Saratoga Hospital Medical Group - Occupational Medicine
PFI: T756
Secondary Site ID: 0000
Certification Type: WAIVER
Director: Michael G Holland, M.D.
Phone: (518) 886-5412
Fax: (518) 899-8069
Address: 2388 Rte 9, Mechanicville, NY 12118
County: Saratoga
Country: United States
Single or Primary Contact: Shayna Blanchette
Contact Phone: (518) 583-8743
CLIA #: 33D2051372
Tests:
Drugs of Abuse Glucose Pregnancy Test (Urine) Urinalysis
12/18/2026
Forestdale Inc
PFI: T757
Secondary Site ID: 0000
Certification Type: WAIVER
Director: Allison R Bloom, M.D.
Phone: (718) 263-0740
Fax: (718) 263-9894
Address: 67-35 112th St - Bldg 3, Forest Hills, NY 11375
County: Queens
Country: United States
Single or Primary Contact: Suchi Kapoor
Contact Phone: (718) 263-0740
CLIA #: 33D2051320
Tests:
COVID-19 ANTIGEN Glucose Hemoglobin Influenza Ketones Pregnancy Test (Urine) RSV (Respiratory Syncytial Virus) Strep A Test Urinalysis
12/18/2026
Jamaica IOP ISSWR Program Lab
PFI: T758
Secondary Site ID: 0000
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (718) 206-1990
Fax: (718) 206-0051
Address: 144-10 Jamaica Avenue, Jamaica, NY 11435
County: Queens
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (718) 206-2000
CLIA #: 33D2054034
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
02/13/2027
Meadow Run Residential Treatment Program
PFI: T758
Secondary Site ID: 0026
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (845) 876-3789
Fax:
Address: 88 Fox Hollow Rd, Rhinebeck, NY 12572
County: Dutchess
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (845) 876-3789
CLIA #: 33D2054034
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
02/13/2027
Fox Run Residential Treatment Program
PFI: T758
Secondary Site ID: 0025
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (845) 516-1000
Fax:
Address: 190 Fox Hollow Rd, Rhinebeck, NY 12572
County: Dutchess
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (845) 516-1000
CLIA #: 33D2054034
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
02/13/2027
Cape Road Residential Treatment Program
PFI: T758
Secondary Site ID: 0024
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (845) 647-6575
Fax:
Address: 767 Cape Rd, Ellenville, NY 12428
County: Ulster
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (845) 647-4592
CLIA #: 33D2054034
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
02/13/2027
ACT
PFI: T758
Secondary Site ID: 0023
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (718) 443-0923
Fax:
Address: 988 Myrtle Ave, Brooklyn, NY 11206
County: Kings
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (718) 443-0923
CLIA #: 33D2054034
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
02/13/2027
Suffolk Outpatient Treatment Program
PFI: T758
Secondary Site ID: 0019
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (631) 351-7113
Fax: (631) 351-0862
Address: 2075 New York Ave, Huntington, NY 11746
County: Suffolk
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (631) 589-9500
CLIA #: 33D2054034
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
02/13/2027
Staten Island Outpatient Treatment Center
PFI: T758
Secondary Site ID: 0018
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (718) 981-3136
Fax: (718) 981-6849
Address: 1915 Forest Ave, Staten Island, NY 10303
County: Richmond
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (929) 678-4894
CLIA #: 33D2054034
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
02/13/2027
Rockland Outpatient Treatment Program
PFI: T758
Secondary Site ID: 0017
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (845) 353-2730
Fax: (845) 353-2538
Address: 602 Rte 303, Blauvelt, NY 10913
County: Rockland
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (845) 353-2538
CLIA #: 33D2054034
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
02/13/2027
Forbell Satellite
PFI: T758
Secondary Site ID: 0015
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (929) 244-1456
Fax: (718) 636-1613
Address: 338 Forbell Avenue, Brooklyn, NY 11208
County: Kings
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (917) 773-7317
CLIA #: 33D2054034
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
02/13/2027
New Beginnings Community Counseling Center
PFI: T758
Secondary Site ID: 0014
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (718) 665-7112
Fax: (718) 665-1174
Address: 510 Courtlandt Avenue 4th Floor, Bronx, NY 10451
County: Bronx
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (718) 665-2456
CLIA #: 33D2054034
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
02/13/2027
Independence Outpatient Treatment Program
PFI: T758
Secondary Site ID: 0013
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (718) 402-9000
Fax: (718) 665-0803
Address: 510 Courtlandt Avenue 5th Floor, Bronx, NY 10451
County: Bronx
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (917) 773-7317
CLIA #: 33D2054034
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
02/13/2027
Mott Haven - OTP
PFI: T758
Secondary Site ID: 0011
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (718) 292-4640
Fax: (718) 402-5006
Address: 362 East 148th Street, Bronx, NY 10455
County: Bronx
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (718) 292-4640
CLIA #: 33D2054034
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
02/13/2027
Richmond Hill - Residential
PFI: T758
Secondary Site ID: 0001
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (718) 441-8913
Fax: (718) 805-6041
Address: 130-20 89th Road, Richmond Hill, NY 11418
County: Queens
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (718) 441-8913
CLIA #: 33D2054034
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
02/13/2027
Young Mothers
PFI: T758
Secondary Site ID: 0002
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (212) 222-5285
Fax: (212) 222-7015
Address: 119 W 106th Street, New York, NY 10025
County: New York
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (212) 222-5285
CLIA #: 33D2054034
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
02/13/2027
Jarrett Place
PFI: T758
Secondary Site ID: 0003
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (718) 681-9300
Fax: (718) 681-8913
Address: 1521 Jarrett Place, Bronx, NY 10461
County: Bronx
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (917) 387-6957
CLIA #: 33D2054034
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
02/13/2027