31D0974669 CLIA NUMBER - BERGEN PEDIATRIC CENTER PC

Laboratory Demographics

  • CLIA Code: 31D0974669
  • Facility Name: BERGEN PEDIATRIC CENTER PC
  • Facility Address: 167SOUTH WASHINGTON AVE
    BERGENFIELD, NJ
    ZIP 07621
  • Facility Phone: 201 384-8510
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OMANA R. MATHEW MD
  • NPI Number: 1750302683
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 31D0974669
LAB Type Physician Office
Facility Name BERGEN PEDIATRIC CENTER PC
Street 167SOUTH WASHINGTON AVE
City BERGENFIELD
State NJ
ZIP 07621
Phone 201 384-8510
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/13/2024
Certificate Expiration Date 6/12/2026
Facility Type Physician Office
Lab Director OMANA R. MATHEW MD

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