31D0875818 CLIA NUMBER - SLPG - ST LUKE'S PRIMARY CARE - WARREN

Laboratory Demographics

  • CLIA Code: 31D0875818
  • Facility Name: SLPG - ST LUKE'S PRIMARY CARE - WARREN
  • Facility Address: 755 MEMORIAL PARKWAY SUITE 102
    PHILLIPSBURG, NJ
    ZIP 08865
  • Facility Phone: 908 847-7560
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAGHUVEER ANNAM
  • NPI Number: 1386735850
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D0875818
LAB Type Physician Office
Facility Name SLPG - ST LUKE'S PRIMARY CARE - WARREN
Street 755 MEMORIAL PARKWAY SUITE 102
City PHILLIPSBURG
State NJ
ZIP 08865
Phone 908 847-7560
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2025
Certificate Expiration Date 9/1/2027
Facility Type Physician Office
Lab Director RAGHUVEER ANNAM

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