31D1091770 CLIA NUMBER - ISLAND MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 31D1091770
  • Facility Name: ISLAND MEDICAL ASSOCIATES
  • Facility Address: 2626 TILTON ROAD
    EGG HARBOR TWP, NJ
    ZIP 08234
  • Facility Phone: 609 568-5000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PETER O. KUPONIYI
  • NPI Number: 1740292119
  • Taxonomy: 207RA0401X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D1091770
LAB Type Physician Office
Facility Name ISLAND MEDICAL ASSOCIATES
Street 2626 TILTON ROAD
City EGG HARBOR TWP
State NJ
ZIP 08234
Phone 609 568-5000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2024
Certificate Expiration Date 2/8/2026
Facility Type Physician Office
Lab Director PETER O. KUPONIYI

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This page was last updated on: 3/20/2025