31D1069721 CLIA NUMBER - DELAWARE VALLEY RETINA ASSOC

Laboratory Demographics

  • CLIA Code: 31D1069721
  • Facility Name: DELAWARE VALLEY RETINA ASSOC
  • Facility Address: 4 PRINCESS ROAD SUITE 101
    LAWRENCEVILLE, NJ
    ZIP 08648
  • Facility Phone: 609 896-1414
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DARMAKUSUMA IE
  • NPI Number: 1336193994
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 31D1069721
LAB Type Physician Office
Facility Name DELAWARE VALLEY RETINA ASSOC
Street 4 PRINCESS ROAD SUITE 101
City LAWRENCEVILLE
State NJ
ZIP 08648
Phone 609 896-1414
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2025
Certificate Expiration Date 6/11/2027
Facility Type Physician Office
Lab Director DARMAKUSUMA IE

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