31D0993429 CLIA NUMBER - CENTRAL JERSEY MEDICAL CENTER

Laboratory Demographics

CLIA Number: 31D0993429

Facility Name: CENTRAL JERSEY MEDICAL CENTER

Facility Address:
275 HOBART STREET
PERTH AMBOY, NJ
ZIP 08861
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Facility Phone Number: 732 376-6673

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1891154993

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D0993429
LAB Type	Federally Qualified Health Center
Facility Name	CENTRAL JERSEY MEDICAL CENTER
Street	275 HOBART STREET
City	PERTH AMBOY
State	NJ
ZIP	08861
Phone	732 376-6673
CertificateType	4
CertificateEffectiveDate	11/14/2023
CertificateExpirationDate	11/13/2025
FacilityType	Waiver

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