31D0975684 CLIA NUMBER - NEW JERSEY UROLOGY

Laboratory Demographics

CLIA Number: 31D0975684

Facility Name: NEW JERSEY UROLOGY

Facility Address:
663 PALISADE AVENUE SUITE 304
CLIFFSIDE PARK, NJ
ZIP 07010
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Facility Phone Number: 201 313-1933

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1699227686

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	31D0975684
LAB Type	Physician Office
Facility Name	NEW JERSEY UROLOGY
Street	663 PALISADE AVENUE SUITE 304
City	CLIFFSIDE PARK
State	NJ
ZIP	07010
Phone	201 313-1933
CertificateType	4
CertificateEffectiveDate	7/13/2022
CertificateExpirationDate	7/12/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024