31D1025730 CLIA NUMBER - ATLANTIC MED GRP WOMEN'S HLTH AT HACKETTSTOWN

Laboratory Demographics

CLIA Number: 31D1025730

Facility Name: ATLANTIC MED GRP WOMEN'S HLTH AT HACKETTSTOWN

Facility Address:
57 ROUTE 46 PATRIOTS PLAZA, SUITE 200
HACKETTSTOWN, NJ
ZIP 07840
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Facility Phone Number: 908 813-8877

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1487852737

Taxonomy: 261QR0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D1025730
LAB Type	Physician Office
Facility Name	ATLANTIC MED GRP WOMEN'S HLTH AT HACKETTSTOWN
Street	57 ROUTE 46 PATRIOTS PLAZA, SUITE 200
City	HACKETTSTOWN
State	NJ
ZIP	07840
Phone	908 813-8877
CertificateType	4
CertificateEffectiveDate	3/18/2023
CertificateExpirationDate	3/17/2025
FacilityType	Waiver

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