31D0974733 CLIA NUMBER - LIBERTY PRIMARY CARE, LLC

Laboratory Demographics

  • CLIA Code: 31D0974733
  • Facility Name: LIBERTY PRIMARY CARE, LLC
  • Facility Address: 1749 HOOPER AVE SUITE 203
    TOMS RIVER, NJ
    ZIP 08753
  • Facility Phone: 732 864-7030
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VINODRAI V. GHETIYA
  • NPI Number: 1699262295
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D0974733
LAB Type Physician Office
Facility Name LIBERTY PRIMARY CARE, LLC
Street 1749 HOOPER AVE SUITE 203
City TOMS RIVER
State NJ
ZIP 08753
Phone 732 864-7030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2024
Certificate Expiration Date 6/14/2026
Facility Type Physician Office
Lab Director VINODRAI V. GHETIYA

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