31D0969394 CLIA NUMBER - ADVOCARE PROMENADE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 31D0969394
  • Facility Name: ADVOCARE PROMENADE PEDIATRICS
  • Facility Address: 528 LIPPINCOTT DR
    MARLTON, NJ
    ZIP 08053
  • Facility Phone: 856 983-3899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAMESH RAGOTHAMAN
  • NPI Number: 1407974512
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 31D0969394
LAB Type Physician Office
Facility Name ADVOCARE PROMENADE PEDIATRICS
Street 528 LIPPINCOTT DR
City MARLTON
State NJ
ZIP 08053
Phone 856 983-3899
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/13/2024
Certificate Expiration Date 1/12/2026
Facility Type Physician Office
Lab Director RAMESH RAGOTHAMAN

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