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 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 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 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 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 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 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 Independence Outpatient Treatment Program PFI: T758Secondary Site ID: 0013Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (718) 402-9000Fax: (718) 665-0803Address: 510 Courtlandt Avenue 5th Floor, Bronx, NY 10451County: BronxCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (917) 773-7317CLIA #: 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 New Beginnings Community Counseling Center PFI: T758Secondary Site ID: 0014Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (718) 665-7112Fax: (718) 665-1174Address: 510 Courtlandt Avenue 4th Floor, Bronx, NY 10451County: BronxCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (718) 665-2456CLIA #: 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 Forbell Satellite PFI: T758Secondary Site ID: 0015Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (929) 244-1456Fax: (718) 636-1613Address: 338 Forbell Avenue, Brooklyn, NY 11208County: KingsCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (917) 773-7317CLIA #: 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 Rockland Outpatient Treatment Program PFI: T758Secondary Site ID: 0017Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (845) 353-2730Fax: (845) 353-2538Address: 602 Rte 303, Blauvelt, NY 10913County: RocklandCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (845) 353-2538CLIA #: 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 Staten Island Outpatient Treatment Center PFI: T758Secondary Site ID: 0018Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (718) 981-3136Fax: (718) 981-6849Address: 1915 Forest Ave, Staten Island, NY 10303County: RichmondCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (929) 678-4894CLIA #: 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 Suffolk Outpatient Treatment Program PFI: T758Secondary Site ID: 0019Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (631) 351-7113Fax: (631) 351-0862Address: 2075 New York Ave, Huntington, NY 11746County: SuffolkCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (631) 589-9500CLIA #: 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 ACT PFI: T758Secondary Site ID: 0023Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (718) 443-0923Fax: Address: 988 Myrtle Ave, Brooklyn, NY 11206County: KingsCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (718) 443-0923CLIA #: 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