Saratoga Hospital Medical Group - Occupational Medicine PFI: T756Secondary Site ID: 0000Certification Type: WAIVERDirector: Michael G Holland, M.D.Phone: (518) 886-5412Fax: (518) 899-8069Address: 2388 Rte 9, Mechanicville, NY 12118County: SaratogaCountry: United StatesSingle or Primary Contact: Shayna BlanchetteContact Phone: (518) 583-8743CLIA #: 33D2051372Tests: Drugs of Abuse Glucose Pregnancy Test (Urine) Urinalysis 12/18/2026 Forestdale Inc PFI: T757Secondary Site ID: 0000Certification Type: WAIVERDirector: Allison R Bloom, M.D.Phone: (718) 263-0740Fax: (718) 263-9894Address: 67-35 112th St - Bldg 3, Forest Hills, NY 11375County: QueensCountry: United StatesSingle or Primary Contact: Suchi KapoorContact Phone: (718) 263-0740CLIA #: 33D2051320Tests: COVID-19 ANTIGEN Glucose Hemoglobin Influenza Ketones Pregnancy Test (Urine) RSV (Respiratory Syncytial Virus) Strep A Test Urinalysis 12/18/2026 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 Cape Road Residential Treatment Program PFI: T758Secondary Site ID: 0024Certification Type: WAIVERDirector: Tatiana Gouskova, M.D.Phone: (845) 647-6575Fax: Address: 767 Cape Rd, Ellenville, NY 12428County: UlsterCountry: United StatesSingle or Primary Contact: Charles MadrayContact Phone: (845) 647-4592CLIA #: 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 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