31D0117637 CLIA NUMBER - ADVOCARE GLENDORA FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 31D0117637
  • Facility Name: ADVOCARE GLENDORA FAMILY PRACTICE
  • Facility Address: 1300 BLACK HORSE PIKE
    GLENDORA, NJ
    ZIP 08029
  • Facility Phone: 856 939-2828
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BENJAMIN R. BLANK DO
  • NPI Number: 1811250541
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D0117637
LAB Type Physician Office
Facility Name ADVOCARE GLENDORA FAMILY PRACTICE
Street 1300 BLACK HORSE PIKE
City GLENDORA
State NJ
ZIP 08029
Phone 856 939-2828
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2025
Certificate Expiration Date 4/3/2027
Facility Type Physician Office
Lab Director BENJAMIN R. BLANK DO

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