31D0122688 CLIA NUMBER - MERIDIAN MEDICAL GROUP-PRIMARY CARE, PC JACKSON PEDIATRICS

Laboratory Demographics

CLIA Number: 31D0122688

Facility Name: MERIDIAN MEDICAL GROUP-PRIMARY CARE, PC JACKSON PEDIATRICS

Facility Address:
21 S HOPE CHAPEL ROAD, SUITE 131
JACKSON, NJ
ZIP 08527
Get Directions

Facility Phone Number: 732 363-1424

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1477955037

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	31D0122688
LAB Type	Physician Office
Facility Name	MERIDIAN MEDICAL GROUP-PRIMARY CARE, PC JACKSON PEDIATRICS
Street	21 S HOPE CHAPEL ROAD, SUITE 131
City	JACKSON
State	NJ
ZIP	08527
Phone	732 363-1424
CertificateType	4
CertificateEffectiveDate	1/24/2023
CertificateExpirationDate	1/23/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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