31D1027827 CLIA NUMBER - PASSAIC PEDIATRICS II PA

Laboratory Demographics

  • CLIA Code: 31D1027827
  • Facility Name: PASSAIC PEDIATRICS II PA
  • Facility Address: 913 MAIN AVENUE
    PASSAIC, NJ
    ZIP 07055
  • Facility Phone: 973 458-8000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARIO MICO
  • NPI Number: 1942256342
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 31D1027827
LAB Type Physician Office
Facility Name PASSAIC PEDIATRICS II PA
Street 913 MAIN AVENUE
City PASSAIC
State NJ
ZIP 07055
Phone 973 458-8000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2024
Certificate Expiration Date 7/14/2026
Facility Type Physician Office
Lab Director MARIO MICO

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