31D0990712 CLIA NUMBER - MERIDIAN MEDICAL GROUP - SPECIALTY CARE

Laboratory Demographics

  • CLIA Code: 31D0990712
  • Facility Name: MERIDIAN MEDICAL GROUP - SPECIALTY CARE
  • Facility Address: 1140 BURNT TAVERN ROAD SUITE 2A
    BRICK, NJ
    ZIP 08724
  • Facility Phone: 732 202-0700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL L. VETTER
  • NPI Number: 1396017000
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 31D0990712
LAB Type Physician Office
Facility Name MERIDIAN MEDICAL GROUP - SPECIALTY CARE
Street 1140 BURNT TAVERN ROAD SUITE 2A
City BRICK
State NJ
ZIP 08724
Phone 732 202-0700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2025
Certificate Expiration Date 8/29/2027
Facility Type Physician Office
Lab Director PAUL L. VETTER

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