31D0716364 CLIA NUMBER - BERGEN INTERNAL MEDICINE, LLC

Laboratory Demographics

  • CLIA Code: 31D0716364
  • Facility Name: BERGEN INTERNAL MEDICINE, LLC
  • Facility Address: 6 HORIZON ROAD LOBBY LEVEL
    FORT LEE, NJ
    ZIP 07024
  • Facility Phone: 201 886-8989
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RICHARD GALLO
  • NPI Number: 1336373539
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 31D0716364
LAB Type Physician Office
Facility Name BERGEN INTERNAL MEDICINE, LLC
Street 6 HORIZON ROAD LOBBY LEVEL
City FORT LEE
State NJ
ZIP 07024
Phone 201 886-8989
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director RICHARD GALLO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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