31D0957843 CLIA NUMBER - ROSANNA A MODESTO MD

Laboratory Demographics

  • CLIA Code: 31D0957843
  • Facility Name: ROSANNA A MODESTO MD
  • Facility Address: 773 TEANECK ROAD
    TEANECK, NJ
    ZIP 07666
  • Facility Phone: 201 837-7662
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROSANNA A. MODESTO MD
  • NPI Number: 1306856778
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D0957843
LAB Type Physician Office
Facility Name ROSANNA A MODESTO MD
Street 773 TEANECK ROAD
City TEANECK
State NJ
ZIP 07666
Phone 201 837-7662
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2025
Certificate Expiration Date 3/2/2027
Facility Type Physician Office
Lab Director ROSANNA A. MODESTO MD

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