31D0690256 CLIA NUMBER - OLD TAPPAN PEDIATRICS

Laboratory Demographics

  • CLIA Code: 31D0690256
  • Facility Name: OLD TAPPAN PEDIATRICS
  • Facility Address: 215 OLD TAPPAN ROAD
    OLD TAPPAN, NJ
    ZIP 07675
  • Facility Phone: 201 666-1001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NANCY ROTHENBERG
  • NPI Number: 1215073515
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 31D0690256
LAB Type Physician Office
Facility Name OLD TAPPAN PEDIATRICS
Street 215 OLD TAPPAN ROAD
City OLD TAPPAN
State NJ
ZIP 07675
Phone 201 666-1001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2025
Certificate Expiration Date 12/31/2026
Facility Type Physician Office
Lab Director NANCY ROTHENBERG

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