31D0110521 CLIA NUMBER - VALLEY PHYSICIAN SERVICES- PC T/A VALLEY MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 31D0110521
  • Facility Name: VALLEY PHYSICIAN SERVICES- PC T/A VALLEY MEDICAL GROUP
  • Facility Address: 1200 E RIDGEWOOD AVENUE, SUITE 307
    RIDGEWOOD, NJ
    ZIP 07450
  • Facility Phone: 201 670-8982
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MITCHELL WEISER
  • NPI Number: 1457626558
  • Taxonomy: 207RC0001X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D0110521
LAB Type Physician Office
Facility Name VALLEY PHYSICIAN SERVICES- PC T/A VALLEY MEDICAL GROUP
Street 1200 E RIDGEWOOD AVENUE, SUITE 307
City RIDGEWOOD
State NJ
ZIP 07450
Phone 201 670-8982
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director MITCHELL WEISER

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