31D0115831 CLIA NUMBER - KENNETH MILLER MD

Laboratory Demographics

  • CLIA Code: 31D0115831
  • Facility Name: KENNETH MILLER MD
  • Facility Address: 16 OLD BROOKSIDE RD
    RANDOLPH, NJ
    ZIP 07869
  • Facility Phone: 201 895-4000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENNETH MILLER MD
  • NPI Number: 1558441238
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D0115831
LAB Type Physician Office
Facility Name KENNETH MILLER MD
Street 16 OLD BROOKSIDE RD
City RANDOLPH
State NJ
ZIP 07869
Phone 201 895-4000
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 KENNETH MILLER MD

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