31D0681859 CLIA NUMBER - MOUNTAINSIDE FAMILY PRACTICE ASSOCIATES

Laboratory Demographics

  • CLIA Code: 31D0681859
  • Facility Name: MOUNTAINSIDE FAMILY PRACTICE ASSOCIATES
  • Facility Address: 799 BLOOMFIELD AVENUE, SUITE 201
    VERONA, NJ
    ZIP 07044
  • Facility Phone: 973 746-7050
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: KEVIN BERG
  • NPI Number: 1295983484
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D0681859
LAB Type Other
Facility Name MOUNTAINSIDE FAMILY PRACTICE ASSOCIATES
Street 799 BLOOMFIELD AVENUE, SUITE 201
City VERONA
State NJ
ZIP 07044
Phone 973 746-7050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2025
Certificate Expiration Date 6/14/2027
Facility Type Other
Lab Director KEVIN BERG

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This page was last updated on: 9/29/2025