31D0122687 CLIA NUMBER - SOMC MEDICAL GROUP, PC

Laboratory Demographics

  • CLIA Code: 31D0122687
  • Facility Name: SOMC MEDICAL GROUP, PC
  • Facility Address: 27 S COOKSBRIDGE ROAD, ST 1-5
    JACKSON, NJ
    ZIP 08527
  • Facility Phone: 732 370-4222
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL S. ROTHBERG
  • NPI Number: 1699004606
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 31D0122687
LAB Type Physician Office
Facility Name SOMC MEDICAL GROUP, PC
Street 27 S COOKSBRIDGE ROAD, ST 1-5
City JACKSON
State NJ
ZIP 08527
Phone 732 370-4222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type Physician Office
Lab Director MICHAEL S. ROTHBERG

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