31D0125094 CLIA NUMBER - NEW JERSEY UROLOGY

Laboratory Demographics

CLIA Number: 31D0125094

Facility Name: NEW JERSEY UROLOGY

Facility Address:
10 PARSONAGE ROAD SUITE 118
EDISON, NJ
ZIP 08837
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Facility Phone Number: 732 494-9400

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1366923344

Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	31D0125094
LAB Type	Physician Office
Facility Name	NEW JERSEY UROLOGY
Street	10 PARSONAGE ROAD SUITE 118
City	EDISON
State	NJ
ZIP	08837
Phone	732 494-9400
CertificateType	4
CertificateEffectiveDate	3/11/2023
CertificateExpirationDate	3/10/2025
FacilityType	Waiver

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