31D1020640 CLIA NUMBER - EVERGREEN PEDIATRICS PC

Laboratory Demographics

  • CLIA Code: 31D1020640
  • Facility Name: EVERGREEN PEDIATRICS PC
  • Facility Address: 1555 CENTER AVE SUITE #1A
    FORT LEE, NJ
    ZIP 07024
  • Facility Phone: 201 224-3344
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: YOON HEE CHOI
  • NPI Number: 1295036291
  • Taxonomy: 171100000X - Acupuncturist

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CLIA Record

Field Name Field Value
CLIA Number 31D1020640
LAB Type Physician Office
Facility Name EVERGREEN PEDIATRICS PC
Street 1555 CENTER AVE SUITE #1A
City FORT LEE
State NJ
ZIP 07024
Phone 201 224-3344
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2023
Certificate Expiration Date 12/28/2025
Facility Type Physician Office
Lab Director YOON HEE CHOI

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