IBR SPECIALTY CLINICAL LABORATORIES
NPI 1962579235
Clinical Medical Laboratory in Staten Island, NY

Active since November 29, 2006CLIA 33D0860102 · Certificate of Compliance
1050 FOREST HILL RD, STATEN ISLAND, NY 10314(718) 494-5345(718) 494-0694 Get Directions Write a Review

NPPES record last updated: February 25, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ibr Specialty Clinical Laboratories NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IBR SPECIALTY CLINICAL LABORATORIES (NPI 1962579235) is a healthcare organization registered as a clinical medical laboratory in Staten Island, New York and active in the NPI registry since November 2006. The organization holds a CLIA Certificate of Compliance certificate valid through March 26, 2027 and lists Edmund C. Jenkins, Lab Director, as its authorized official.

NPPES Registry Identity

NPI1962579235
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameSTATE OF NEW YORK
Location Address1050 FOREST HILL RDStaten Island, NY 10314-6356
Mailing Address1050 Forest Hill RdStaten Island, NY 10314-6356 · (718) 494-5345 · Fax (718) 494-0694
Fax(718) 494-0694
Organization SubpartNo
Authorized OfficialEdmund C. JenkinsLab Director · (718) 494-5236
Enumeration DateNovember 29, 2006
Last NPPES UpdateFebruary 25, 2009
NPI 1962579235 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in NY · 7097M040
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
1050 FOREST HILL RD, Staten Island, NY 10314

Other Names 1

Other NameIbr Specialty Clinical Laboratories

Other Identifiers 4

Other7097M040NY · Nys Lab License
Medicaid00782518NY
Other33D0860102Clia
Medicare ID-Type Unspecified33-8496

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 33D0860102

Ibr Specialty Clinical Laboratories · Staten Island, NY
Active · expires Mar 26, 2027
CLIA Number33D0860102
Laboratory TypeIndependent
Certificate Effective DateAugust 28, 1995
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Tatyana Adayev
Laboratory Phone(718) 494-5345
Laboratory LocationIbr Specialty Clinical Laboratories1050 Forest Hill Road, Staten Island, NY 10314
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Clinical)
1050 FOREST HILL RD
STATEN ISLAND, NY 10314
Registered Nurse
1050 FOREST HILL RD
STATEN ISLAND, NY 10314
Social Worker (Clinical)
1050 FOREST HILL RD
STATEN ISLAND, NY 10314
Early Intervention Provider Agency
1050 FOREST HILL RD
STATEN ISLAND, NY 10314
Psychiatry & Neurology (Neurology)
1050 FOREST HILL RD, GEORGE JERVIS CLINIC
STATEN ISLAND, NY 10314
Genetic Counselor, MS
1050 FOREST HILL RD
STATEN ISLAND, NY 10314
Speech-Language Pathologist
1050 FOREST HILL RD
STATEN ISLAND, NY 10314
Psychologist (Clinical)
1050 FOREST HILL RD
STATEN ISLAND, NY 10314

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is State Of New York's NPI number?

The NPI number for State Of New York is 1962579235. It was assigned to this organization in the NPPES registry on November 29, 2006. The provider is also known as Ibr Specialty Clinical Laboratories.

Where is State Of New York located?

State Of New York is located at 1050 Forest Hill Rd, Staten Island, NY 10314. The listed phone number is (718) 494-5345.

What is State Of New York's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does State Of New York hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 33D0860102) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for State Of New York was last updated on February 25, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.