Van Wyck Admissions and Residential
PFI: T758
Secondary Site ID: 0004
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (718) 657-6195
Fax: (718) 297-9041
Address: 88-83 Van Wyck Expressway, Jamaica, NY 11435
County: Queens
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (718) 647-8010
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
Ellenville and Ellenville Women's Vets
PFI: T758
Secondary Site ID: 0005
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (845) 647-4592
Fax: (845) 701-1601
Address: 751 Briggs Hwy, Ellenville, NY 12428
County: Ulster
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
43rd Veterans
PFI: T758
Secondary Site ID: 0006
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (212) 333-5445
Fax: (212) 307-7382
Address: 327 W 43rd Street, New York, NY 10036
County: New York
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
Ed Thompson
PFI: T758
Secondary Site ID: 0007
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (718) 849-3582
Fax: (718) 850-3914
Address: 130-15 89th Road, Richmond Hill, NY 11418
County: Queens
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
106 Community Residence
PFI: T758
Secondary Site ID: 0008
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (212) 864-4128
Fax: (212) 663-9193
Address: 68 W 106th Street, New York, NY 10025
County: New York
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
Harlem OP
PFI: T758
Secondary Site ID: 0009
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (212) 864-4128
Fax: (212) 904-1515
Address: 2090 Adam Clayton Powell Blvd-Flr 7, New York, NY 10027
County: New York
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (718) 704-3910
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
Grand Concourse Outpatient Treatment Program
PFI: T758
Secondary Site ID: 0010
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (718) 292-4455
Fax: (718) 292-9228
Address: 250 Grand Concourse, Bronx, NY 10451
County: Bronx
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (718) 292-4455
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
Bronx Outpatient Treatment Program
PFI: T758
Secondary Site ID: 0012
Certification Type: WAIVER
Director: Tatiana Gouskova, M.D.
Phone: (718) 518-9007
Fax: (718) 518-8281
Address: 900 Arnow Avenue, Bronx, NY 10469
County: Bronx
Country: United States
Single or Primary Contact: Charles Madray
Contact Phone: (929) 218-0878
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
Open Door Family Medical Center
PFI: T759
Secondary Site ID: 0000
Certification Type: WAIVER
Director: Daren Wu, M.D.
Phone: (845) 279-6999
Fax: (845) 279-0908
Address: 155 Main Street, Brewster, NY 10509
County: Putnam
Country: United States
Single or Primary Contact: Madhuri Nicola
Contact Phone: (914) 881-3769
CLIA #: 33D2054395
Tests:
COVID-19 ANTIGEN Cholesterol Community Screening Drugs of Abuse Glucose Glycosylated Hemoglobin HDL Cholesterol Hemoglobin Influenza LDL Cholesterol Microalbumin pH Pregnancy Test (Urine) COVID-19 MOLECULAR HIV, Rapid RSV (Respiratory Syncytial Virus) Strep A Test Triglycerides Urinalysis
02/22/2027
Tully Hill Corporation
PFI: T760
Secondary Site ID: 0000
Certification Type: PPMP
Director: Gregory T Serfer, D.O.
Phone: (315) 696-6114
Fax: (315) 696-8509
Address: 5821 Rte 80, Tully, NY 13159
County: Onondaga
Country: United States
Single or Primary Contact: Cathy L Palm
Contact Phone: (315) 696-6114
CLIA #: 33D2060407
Tests:
Breath Alcohol Carbon Monoxide Breath Testing Drugs of Abuse Ethanol Glucose Influenza Nicotine Occult Blood Potassium Hydroxide (KOH Preps) Pregnancy Test (Urine) Strep A Test Urinalysis
06/13/2027
Wyckoff Pediatric Center
PFI: T767
Secondary Site ID: 0000
Certification Type: WAIVER
Director: Wilhelmina P. Cruz-Vetrano, M.D.
Phone: (718) 907-4301
Fax:
Address: 1411 Myrtle Ave, Brooklyn, NY 11237
County: Kings
Country: United States
Single or Primary Contact: Alexandra Zubok
Contact Phone: (718) 963-7519
CLIA #: 33D2054035
Tests:
Community Screening Glucose Glycosylated Hemoglobin Influenza Pregnancy Test (Urine) COVID-19 MOLECULAR RSV (Respiratory Syncytial Virus) Strep A Test Urinalysis
07/31/2027
Wyckoff Heights Medical Center WIC Program Local Agency 285
PFI: T770
Secondary Site ID: 0000
Certification Type: WAIVER
Director: Wilhelmina P. Cruz-Vetrano, M.D.
Phone: (718) 963-6537
Fax: (718) 963-6536
Address: 316 A Himrod St, Brooklyn, NY 11237
County: Kings
Country: United States
Single or Primary Contact: Andrew Chambers
Contact Phone: (718) 963-7519
CLIA #: 33D2051323
Tests:
12/18/2026
Volunteer Ambulance Corps of Bath NY Inc
PFI: T771
Secondary Site ID: 0000
Certification Type: WAIVER
Director: Werner K Brammer, M.D.
Phone: (607) 776-3156
Fax: (607) 776-8475
Address: 110 E Steuben Street, Bath, NY 14810
County: Steuben
Country: United States
Single or Primary Contact: Carole Tombs
Contact Phone: (607) 776-3156
CLIA #: 33D2054036
Tests:
07/29/2025
Upstate Gastroenterology LLC
PFI: T774
Secondary Site ID: 0000
Certification Type: WAIVER
Director: John Savio, M.D.
Phone: (315) 464-1616
Fax: (315) 464-1617
Address: 1000 E Genesee St - Suite 206, Syracuse, NY 13210
County: Onondaga
Country: United States
Single or Primary Contact: Lorraine Brissenden
Contact Phone: (315) 464-5402
CLIA #: 33D1051896
Tests:
01/10/2027
Mount Sinai Beth Israel Medical Group
PFI: T775
Secondary Site ID: 0000
Certification Type: WAIVER
Director: Elizabeth B Enschede, M.D.
Phone: (718) 218-0450
Fax: (718) 218-0451
Address: 135 N 7th Street, Brooklyn, NY 11211
County: Kings
Country: United States
Single or Primary Contact: Laurie Kubot
Contact Phone: (718) 218-0453
CLIA #: 33D2054590
Tests:
Bacterial Vaginosis, Rapid Blood Lead Glucose Glycosylated Hemoglobin Hemoglobin Helicobacter Pylori Influenza Mononucleosis Occult Blood Pregnancy Test (Urine) Trichomonas, Rapid HCV, Rapid HIV, Rapid RSV (Respiratory Syncytial Virus) Strep A Test Urinalysis
03/01/2027
Town Line Fire Department Station 2
PFI: T776
Secondary Site ID: 0001
Certification Type: WAIVER
Director: John J McNamara, D.O.
Phone: (716) 681-1550
Fax: (716) 683-0658
Address: 63 Cemetery Road, Lancaster, NY 14086
County: Erie
Country: United States
Single or Primary Contact: Brett Broska
Contact Phone: (716) 683-0385
CLIA #: 33D2051477
Tests:
12/21/2026
Town Line Volunteer Fire Department Inc
PFI: T776
Secondary Site ID: 0000
Certification Type: WAIVER
Director: John J McNamara, D.O.
Phone: (716) 683-0385
Fax: (716) 683-0658
Address: 6507 Broadway, Lancaster, NY 14086
County: Erie
Country: United States
Single or Primary Contact: Brett Broska
Contact Phone: (716) 683-0385
CLIA #: 33D2051477
Tests:
12/21/2026
Saratoga Hospital Medical Group - Primary Care Malta
PFI: T778
Secondary Site ID: 0001
Certification Type: PPMP
Director: Karin E Borrelli, M.D.
Phone: (518) 886-7568
Fax: (518) 886-7569
Address: 8 Medical Park Drive - Ste 100, Malta, NY 12020
County: Saratoga
Country: United States
Single or Primary Contact: Shayna Blanchette
Contact Phone: (518) 583-8743
CLIA #: 33D0863145
Tests:
COVID-19 ANTIGEN Blood Lead Drugs of Abuse Direct Wet Mount Preps Glucose Glycosylated Hemoglobin Influenza Mononucleosis Occult Blood Potassium Hydroxide (KOH Preps) Protime Pregnancy Test (Urine) Strep A Test Urinalysis
04/01/2027
Saratoga Hospital Medical Group Primary Care - Scotia-Glenville
PFI: T778
Secondary Site ID: 0000
Certification Type: PPMP
Director: Karin E Borrelli, M.D.
Phone: (518) 399-7723
Fax: (518) 399-6428
Address: 112 Charlton Road, Ballston Lake, NY 12019
County: Schenectady
Country: United States
Single or Primary Contact: Shayna Blanchette
Contact Phone: (518) 583-8743
CLIA #: 33D0863145
Tests:
COVID-19 ANTIGEN Blood Lead Drugs of Abuse Direct Wet Mount Preps Glucose Glycosylated Hemoglobin Influenza Mononucleosis Occult Blood Potassium Hydroxide (KOH Preps) Protime Pregnancy Test (Urine) Strep A Test Urinalysis
04/01/2027
St Francis Cardiovascular Physicians PC Great South Bay Med Practice
PFI: T780
Secondary Site ID: 0000
Certification Type: WAIVER
Director: Raymond L Ebarb, M.D.
Phone: (631) 563-6205
Fax: (631) 563-7718
Address: 213 Montauk Highway, West Sayville, NY 11796
County: Suffolk
Country: United States
Single or Primary Contact: Maria Demaille
Contact Phone: (631) 563-1215
CLIA #: 33D0702174
Tests:
Glucose Glycosylated Hemoglobin Hemoglobin Influenza Microalbumin Occult Blood Protime Pregnancy Test (Urine) Strep A Test Urinalysis
03/25/2027