31D1015964 CLIA NUMBER - MY MD GROUP

Laboratory Demographics

CLIA Number: 31D1015964

Facility Name: MY MD GROUP

Facility Address:
201 NORTH COUNTY LINE ROAD
JACKSON, NJ
ZIP 08527
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Facility Phone Number: 732 901-8880

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1811121916

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name	Field Value
CLIA Number	31D1015964
LAB Type	Physician Office
Facility Name	MY MD GROUP
Street	201 NORTH COUNTY LINE ROAD
City	JACKSON
State	NJ
ZIP	08527
Phone	732 901-8880
CertificateType	4
CertificateEffectiveDate	8/18/2023
CertificateExpirationDate	8/17/2025
FacilityType	Waiver

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