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31D0111810 CLIA NUMBER - PEDIATRICARE ASSOCIATES

Laboratory Demographics

CLIA Number: 31D0111810

Facility Name: PEDIATRICARE ASSOCIATES

Facility Address:
90 PROSPECT AVE
HACKENSACK, NJ
ZIP 07601
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Facility Phone Number: 201 342-4001

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1699888065

Taxonomy: 204C00000X - Neuromusculoskeletal Medicine, Sports Medicine
A Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation. Source: American Osteopathic Association Additional Resources: AOA Osteopathic Board Certification in Neuromusculoskeletal Medicine; https://certification.osteopathic.org/sports-medicine/

CLIA Record

Field Name Field Value
CLIA Number 31D0111810
LAB Type Physician Office
Facility Name PEDIATRICARE ASSOCIATES
Street 90 PROSPECT AVE
City HACKENSACK
State NJ
ZIP 07601
Phone 201 342-4001
CertificateType 4
CertificateEffectiveDate 10/26/2023
CertificateExpirationDate 10/25/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024