31D0122937 CLIA NUMBER - ADVANCED UROLOGY ASSOCIATES ENTERPRISES, LLC

Laboratory Demographics

CLIA Number: 31D0122937

Facility Name: ADVANCED UROLOGY ASSOCIATES ENTERPRISES, LLC

Facility Address:
446 JACK MARTIN BLVD
BRICK, NJ
ZIP 08724
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Facility Phone Number: 732 840-4300

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1720479769

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D0122937
LAB Type	Physician Office
Facility Name	ADVANCED UROLOGY ASSOCIATES ENTERPRISES, LLC
Street	446 JACK MARTIN BLVD
City	BRICK
State	NJ
ZIP	08724
Phone	732 840-4300
CertificateType	4
CertificateEffectiveDate	3/2/2024
CertificateExpirationDate	3/1/2026
FacilityType	Waiver

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