31D1007402 CLIA NUMBER - PEDIATRIC AND ADOLESCENT ASSOCIATES 0F CENTRAL NJ LLC

Laboratory Demographics

CLIA Number: 31D1007402

Facility Name: PEDIATRIC AND ADOLESCENT ASSOCIATES 0F CENTRAL NJ LLC

Facility Address:
100 PERRINE ROAD
OLD BRIDGE, NJ
ZIP 08857
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Facility Phone Number: 732 316-0900

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1912117599

Taxonomy: 2080A0000X - Pediatrics
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

CLIA Record

Field Name	Field Value
CLIA Number	31D1007402
LAB Type	Physician Office
Facility Name	PEDIATRIC AND ADOLESCENT ASSOCIATES 0F CENTRAL NJ LLC
Street	100 PERRINE ROAD
City	OLD BRIDGE
State	NJ
ZIP	08857
Phone	732 316-0900
CertificateType	4
CertificateEffectiveDate	10/16/2022
CertificateExpirationDate	10/15/2024
FacilityType	Waiver

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