Fox Run Residential Treatment Program PFI: T758Secondary Site ID: 0025Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (845) 516-1000Fax: Address: 190 Fox Hollow Rd, Rhinebeck, NY 12572County: DutchessCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (845) 516-1000CLIA #: 33D2054034Tests: 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: T758Secondary Site ID: 0026Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (845) 876-3789Fax: Address: 88 Fox Hollow Rd, Rhinebeck, NY 12572County: DutchessCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (845) 876-3789CLIA #: 33D2054034Tests: 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 Jamaica IOP ISSWR Program Lab PFI: T758Secondary Site ID: 0000Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (718) 206-1990Fax: (718) 206-0051Address: 144-10 Jamaica Avenue, Jamaica, NY 11435County: QueensCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (718) 206-2000CLIA #: 33D2054034Tests: 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: T758Secondary Site ID: 0011Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (718) 292-4640Fax: (718) 402-5006Address: 362 East 148th Street, Bronx, NY 10455County: BronxCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (718) 292-4640CLIA #: 33D2054034Tests: 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: T758Secondary Site ID: 0012Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (718) 518-9007Fax: (718) 518-8281Address: 900 Arnow Avenue, Bronx, NY 10469County: BronxCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (929) 218-0878CLIA #: 33D2054034Tests: 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: T758Secondary Site ID: 0001Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (718) 441-8913Fax: (718) 805-6041Address: 130-20 89th Road, Richmond Hill, NY 11418County: QueensCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (718) 441-8913CLIA #: 33D2054034Tests: 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: T758Secondary Site ID: 0002Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (212) 222-5285Fax: (212) 222-7015Address: 119 W 106th Street, New York, NY 10025County: New YorkCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (212) 222-5285CLIA #: 33D2054034Tests: 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: T758Secondary Site ID: 0003Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (718) 681-9300Fax: (718) 681-8913Address: 1521 Jarrett Place, Bronx, NY 10461County: BronxCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (917) 387-6957CLIA #: 33D2054034Tests: 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 Van Wyck Admissions and Residential PFI: T758Secondary Site ID: 0004Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (718) 657-6195Fax: (718) 297-9041Address: 88-83 Van Wyck Expressway, Jamaica, NY 11435County: QueensCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (718) 647-8010CLIA #: 33D2054034Tests: 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: T758Secondary Site ID: 0005Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (845) 647-4592Fax: (845) 701-1601Address: 751 Briggs Hwy, Ellenville, NY 12428County: UlsterCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (917) 387-6957CLIA #: 33D2054034Tests: 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: T758Secondary Site ID: 0007Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (718) 849-3582Fax: (718) 850-3914Address: 130-15 89th Road, Richmond Hill, NY 11418County: QueensCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (917) 387-6957CLIA #: 33D2054034Tests: 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: T758Secondary Site ID: 0006Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (212) 333-5445Fax: (212) 307-7382Address: 327 W 43rd Street, New York, NY 10036County: New YorkCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (917) 387-6957CLIA #: 33D2054034Tests: 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: T758Secondary Site ID: 0010Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (718) 292-4455Fax: (718) 292-9228Address: 250 Grand Concourse, Bronx, NY 10451County: BronxCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (718) 292-4455CLIA #: 33D2054034Tests: 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: T758Secondary Site ID: 0009Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (212) 864-4128Fax: (212) 904-1515Address: 2090 Adam Clayton Powell Blvd-Flr 7, New York, NY 10027County: New YorkCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (718) 704-3910CLIA #: 33D2054034Tests: 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: T758Secondary Site ID: 0008Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (212) 864-4128Fax: (212) 663-9193Address: 68 W 106th Street, New York, NY 10025County: New YorkCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (917) 387-6957CLIA #: 33D2054034Tests: 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: T759Secondary Site ID: 0000Certification Type: WAIVERDirector: Daren Wu, M.D.Phone: (845) 279-6999Fax: (845) 279-0908Address: 155 Main Street, Brewster, NY 10509County: PutnamCountry: United StatesSingle or Primary Contact: Madhuri NicolaContact Phone: (914) 881-3769CLIA #: 33D2054395Tests: 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: T760Secondary Site ID: 0000Certification Type: PPMPDirector: Gregory T Serfer, D.O.Phone: (315) 696-6114Fax: (315) 696-8509Address: 5821 Rte 80, Tully, NY 13159County: OnondagaCountry: United StatesSingle or Primary Contact: Cathy L PalmContact Phone: (315) 696-6114CLIA #: 33D2060407Tests: 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: T767Secondary Site ID: 0000Certification Type: WAIVERDirector: Wilhelmina P. Cruz-Vetrano, M.D.Phone: (718) 907-4301Fax: Address: 1411 Myrtle Ave, Brooklyn, NY 11237County: KingsCountry: United StatesSingle or Primary Contact: Alexandra ZubokContact Phone: (718) 963-7519CLIA #: 33D2054035Tests: 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: T770Secondary Site ID: 0000Certification Type: WAIVERDirector: Wilhelmina P. Cruz-Vetrano, M.D.Phone: (718) 963-6537Fax: (718) 963-6536Address: 316 A Himrod St, Brooklyn, NY 11237County: KingsCountry: United StatesSingle or Primary Contact: Andrew ChambersContact Phone: (718) 963-7519CLIA #: 33D2051323Tests: 12/18/2026 Volunteer Ambulance Corps of Bath NY Inc PFI: T771Secondary Site ID: 0000Certification Type: WAIVERDirector: Werner K Brammer, M.D.Phone: (607) 776-3156Fax: (833) 980-0271Address: 110 E Steuben Street, Bath, NY 14810County: SteubenCountry: United StatesSingle or Primary Contact: Michelle SmithContact Phone: (607) 776-3156CLIA #: 33D2054036Tests: 07/29/2027