31D0672050 CLIA NUMBER - CHESTNUT RIDGE PEDIATRICS ASSOC

Laboratory Demographics

  • CLIA Code: 31D0672050
  • Facility Name: CHESTNUT RIDGE PEDIATRICS ASSOC
  • Facility Address: 135 CHESTNUT RIDGE ROAD SUITE 1120
    MONTVALE, NJ
    ZIP 07645
  • Facility Phone: (201) 391-2020
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK S. MANDEL
  • NPI Number: 1568400141
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 31D0672050
LAB Type Physician Office
Facility Name CHESTNUT RIDGE PEDIATRICS ASSOC
Street 135 CHESTNUT RIDGE ROAD SUITE 1120
City MONTVALE
State NJ
ZIP 07645
Phone 2013912020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Physician Office
Lab Director MARK S. MANDEL

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This page was last updated on: 5/18/2026