31D1044685 CLIA NUMBER - COOPER PHYSICIAN OFFFICES

Laboratory Demographics

CLIA Code: 31D1044685
Facility Name: COOPER PHYSICIAN OFFFICES
Facility Address: 196 GROVE AVENUE SUITE C ATTN PRACTIC MANAGER
THOROFARE, NJ
ZIP 08086
Facility Phone: 856 848-7577
Facility Type: Physician Office
Facility Type: Microscopy
Lab Director: NIDHI AGRAWAL
NPI Number: 1063616399
Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name	Field Value
CLIA Number	31D1044685
LAB Type	Physician Office
Facility Name	COOPER PHYSICIAN OFFFICES
Street	196 GROVE AVENUE SUITE C ATTN PRACTIC MANAGER
City	THOROFARE
State	NJ
ZIP	08086
Phone	856 848-7577
Certificate Type	Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description	This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date	2/19/2025
Certificate Expiration Date	2/18/2027
Facility Type	Physician Office
Lab Director	NIDHI AGRAWAL

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