31D0896375 CLIA NUMBER - PPNCSNJ - PERTH AMBOY

Laboratory Demographics

  • CLIA Code: 31D0896375
  • Facility Name: PPNCSNJ - PERTH AMBOY
  • Facility Address: 450 MARKET STREET
    PERTH AMBOY, NJ
    ZIP 08861
  • Facility Phone: 732 228-8129
  • Facility Type: Other - AMBULATORY CARE CENTER
  • Facility Type: Microscopy
  • Lab Director: DANIEL SMALL
  • NPI Number: 1639435811
  • Taxonomy: 261QA0005X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D0896375
LAB Type Other - AMBULATORY CARE CENTER
Facility Name PPNCSNJ - PERTH AMBOY
Street 450 MARKET STREET
City PERTH AMBOY
State NJ
ZIP 08861
Phone 732 228-8129
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 12/21/2023
Certificate Expiration Date 12/20/2025
Facility Type Other - AMBULATORY CARE CENTER
Lab Director DANIEL SMALL

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