31D0954376 CLIA NUMBER - WATCHUNG PEDIATRICS

Laboratory Demographics

  • CLIA Code: 31D0954376
  • Facility Name: WATCHUNG PEDIATRICS
  • Facility Address: 346 SOUTH AVENUE SUITE 3
    FANWOOD, NJ
    ZIP 07023
  • Facility Phone: 908 755-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BONITA GILLARD
  • NPI Number: 1225021181
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 31D0954376
LAB Type Physician Office
Facility Name WATCHUNG PEDIATRICS
Street 346 SOUTH AVENUE SUITE 3
City FANWOOD
State NJ
ZIP 07023
Phone 908 755-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Physician Office
Lab Director BONITA GILLARD

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