31D0706778 CLIA NUMBER - ADVOCARE PEDIATRIC AND ADULT MEDICINE

Laboratory Demographics

  • CLIA Code: 31D0706778
  • Facility Name: ADVOCARE PEDIATRIC AND ADULT MEDICINE
  • Facility Address: 311 THE PAVILIONS AT GREENTREE 12000 LINCOLN DRIVE WEST
    MARLTON, NJ
    ZIP 08053
  • Facility Phone: 856 985-8100
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: S JAY MIRMANESH MD
  • NPI Number: 1083902720
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 31D0706778
LAB Type Physician Office
Facility Name ADVOCARE PEDIATRIC AND ADULT MEDICINE
Street 311 THE PAVILIONS AT GREENTREE 12000 LINCOLN DRIVE WEST
City MARLTON
State NJ
ZIP 08053
Phone 856 985-8100
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/18/2025
Certificate Expiration Date 1/17/2027
Facility Type Physician Office
Lab Director S JAY MIRMANESH MD

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