31D1052817 CLIA NUMBER - NORTH JERSEY INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 31D1052817
  • Facility Name: NORTH JERSEY INTERNAL MEDICINE
  • Facility Address: 92 SUMMIT AVENUE
    HACKENSACK, NJ
    ZIP 07601
  • Facility Phone: 201 342-0066
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EHAB IBRAHIM MD
  • NPI Number: 1114027885
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D1052817
LAB Type Physician Office
Facility Name NORTH JERSEY INTERNAL MEDICINE
Street 92 SUMMIT AVENUE
City HACKENSACK
State NJ
ZIP 07601
Phone 201 342-0066
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2024
Certificate Expiration Date 4/4/2026
Facility Type Physician Office
Lab Director EHAB IBRAHIM MD

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