31D0960912 CLIA NUMBER - GASTROENTEROLOGY ASSOCIATES OF NEW JERSEY, LLC

Laboratory Demographics

  • CLIA Code: 31D0960912
  • Facility Name: GASTROENTEROLOGY ASSOCIATES OF NEW JERSEY, LLC
  • Facility Address: 9252 KENNEDY BOULEVARD
    NORTH BERGEN, NJ
    ZIP 07047
  • Facility Phone: 973 785-2277
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. WEN FAN
  • NPI Number: 1689784381
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D0960912
LAB Type Physician Office
Facility Name GASTROENTEROLOGY ASSOCIATES OF NEW JERSEY, LLC
Street 9252 KENNEDY BOULEVARD
City NORTH BERGEN
State NJ
ZIP 07047
Phone 973 785-2277
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2024
Certificate Expiration Date 3/31/2026
Facility Type Physician Office
Lab Director DR. WEN FAN

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