31D0874748 CLIA NUMBER - MPV NEW JERSEY MD SERVICES, ACUTE CARE CENTER

Laboratory Demographics

  • CLIA Code: 31D0874748
  • Facility Name: MPV NEW JERSEY MD SERVICES, ACUTE CARE CENTER
  • Facility Address: 557 BROAD STREET
    BLOOMFIELD, NJ
    ZIP 07003
  • Facility Phone: 201 383-1907
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL I. BASISTA
  • NPI Number: 1801542816
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 31D0874748
LAB Type Physician Office
Facility Name MPV NEW JERSEY MD SERVICES, ACUTE CARE CENTER
Street 557 BROAD STREET
City BLOOMFIELD
State NJ
ZIP 07003
Phone 201 383-1907
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2024
Certificate Expiration Date 1/19/2026
Facility Type Physician Office
Lab Director MICHAEL I. BASISTA

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