31D0109297 CLIA NUMBER - NEW JERSEY KIDNEY CARE, LLC

Laboratory Demographics

  • CLIA Code: 31D0109297
  • Facility Name: NEW JERSEY KIDNEY CARE, LLC
  • Facility Address: 26 GREENVILLE AVENUE
    JERSEY CITY, NJ
    ZIP 07305
  • Facility Phone: 201 333-8222
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BASSAM HADDAD
  • NPI Number: 1194277392
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D0109297
LAB Type Physician Office
Facility Name NEW JERSEY KIDNEY CARE, LLC
Street 26 GREENVILLE AVENUE
City JERSEY CITY
State NJ
ZIP 07305
Phone 201 333-8222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2024
Certificate Expiration Date 7/31/2026
Facility Type Physician Office
Lab Director BASSAM HADDAD

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This page was last updated on: 9/29/2025