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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
06/13/2025
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: Andrew Chambers
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
07/31/2025
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