31D0877722 CLIA NUMBER - COMPREHENSIVE PEDIATRIC CARE PC

Laboratory Demographics

  • CLIA Code: 31D0877722
  • Facility Name: COMPREHENSIVE PEDIATRIC CARE PC
  • Facility Address: 119 PROSPECT STREET
    RIDGEWOOD, NJ
    ZIP 07450
  • Facility Phone: 201 445-1212
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ZIA GHAVAMI
  • NPI Number: 1336441336
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 31D0877722
LAB Type Physician Office
Facility Name COMPREHENSIVE PEDIATRIC CARE PC
Street 119 PROSPECT STREET
City RIDGEWOOD
State NJ
ZIP 07450
Phone 201 445-1212
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2023
Certificate Expiration Date 10/21/2025
Facility Type Physician Office
Lab Director ZIA GHAVAMI

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