31D0111383 CLIA NUMBER - HAWTHORNE FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 31D0111383
  • Facility Name: HAWTHORNE FAMILY PRACTICE
  • Facility Address: 1083 GOFFLE ROAD
    HAWTHORNE, NJ
    ZIP 07506
  • Facility Phone: 973 427-2421
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ENAS TUPPO MD
  • NPI Number: 1588878300
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 31D0111383
LAB Type Physician Office
Facility Name HAWTHORNE FAMILY PRACTICE
Street 1083 GOFFLE ROAD
City HAWTHORNE
State NJ
ZIP 07506
Phone 973 427-2421
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 ENAS TUPPO MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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