31D1030806 CLIA NUMBER - IVY PEDIATRICS PA

Laboratory Demographics

  • CLIA Code: 31D1030806
  • Facility Name: IVY PEDIATRICS PA
  • Facility Address: 220 BRIDGE PLAZA DRIVE
    MANALAPAN, NJ
    ZIP 07726
  • Facility Phone: 732 972-9525
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IGOR TROGAN
  • NPI Number: 1871660407
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 31D1030806
LAB Type Physician Office
Facility Name IVY PEDIATRICS PA
Street 220 BRIDGE PLAZA DRIVE
City MANALAPAN
State NJ
ZIP 07726
Phone 732 972-9525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2025
Certificate Expiration Date 8/1/2027
Facility Type Physician Office
Lab Director IGOR TROGAN

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