31D1040230 CLIA NUMBER - TATYANA FAST MD PC

Laboratory Demographics

  • CLIA Code: 31D1040230
  • Facility Name: TATYANA FAST MD PC
  • Facility Address: 160 WHITE ROAD S-102
    LITTLE SILVER, NJ
    ZIP 07739
  • Facility Phone: (732) 450-0062
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. TATYANA FAST
  • NPI Number: 1437898905
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D1040230
LAB Type Physician Office
Facility Name TATYANA FAST MD PC
Street 160 WHITE ROAD S-102
City LITTLE SILVER
State NJ
ZIP 07739
Phone 7324500062
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Physician Office
Lab Director DR. TATYANA FAST

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This page was last updated on: 5/18/2026