31D0872076 CLIA NUMBER - ILEANA ANTONIADIS

Laboratory Demographics

  • CLIA Code: 31D0872076
  • Facility Name: ILEANA ANTONIADIS
  • Facility Address: 207 ROUTE 71
    SPRING LAKE HEIGHTS, NJ
    ZIP 07762
  • Facility Phone: 732 359-7232
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ILEANA ANTONIADIS
  • NPI Number: 1699752634
  • Taxonomy: 207RR0500X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D0872076
LAB Type Physician Office
Facility Name ILEANA ANTONIADIS
Street 207 ROUTE 71
City SPRING LAKE HEIGHTS
State NJ
ZIP 07762
Phone 732 359-7232
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2025
Certificate Expiration Date 6/8/2027
Facility Type Physician Office
Lab Director ILEANA ANTONIADIS

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