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31D0122945 CLIA NUMBER - OPTUM MEDICAL CARE OF NJ PC

Laboratory Demographics

CLIA Number: 31D0122945

Facility Name: OPTUM MEDICAL CARE OF NJ PC

Facility Address:
525 JACK MARTIN BLVD
BRICK, NJ
ZIP 08724
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Facility Phone Number: 732 458-1177

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1306949508

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name Field Value
CLIA Number 31D0122945
LAB Type Physician Office
Facility Name OPTUM MEDICAL CARE OF NJ PC
Street 525 JACK MARTIN BLVD
City BRICK
State NJ
ZIP 08724
Phone 732 458-1177
CertificateType 4
CertificateEffectiveDate 5/23/2022
CertificateExpirationDate 5/22/2024
FacilityType Waiver

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