31D1009602 CLIA NUMBER - SHORE NEPHROLOGY PA

Laboratory Demographics

CLIA Number: 31D1009602

Facility Name: SHORE NEPHROLOGY PA

Facility Address:
2100 CORLIES AVE, SUITE 15
NEPTUNE, NJ
ZIP 07753
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Facility Phone Number: 732 988-8228

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1003926171

Taxonomy: 207RN0300X - Internal Medicine
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

CLIA Record

Field Name	Field Value
CLIA Number	31D1009602
LAB Type	Physician Office
Facility Name	SHORE NEPHROLOGY PA
Street	2100 CORLIES AVE, SUITE 15
City	NEPTUNE
State	NJ
ZIP	07753
Phone	732 988-8228
CertificateType	4
CertificateEffectiveDate	2/20/2023
CertificateExpirationDate	2/19/2025
FacilityType	Waiver

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