31D1095130 CLIA NUMBER - MEDAMERICA GROUP LLC

Laboratory Demographics

  • CLIA Code: 31D1095130
  • Facility Name: MEDAMERICA GROUP LLC
  • Facility Address: 5301 WELLINGTON AVE
    VENTNOR CITY, NJ
    ZIP 08406
  • Facility Phone: 609 823-0555
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK P. ALEXANDER
  • NPI Number: 1568617819
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D1095130
LAB Type Physician Office
Facility Name MEDAMERICA GROUP LLC
Street 5301 WELLINGTON AVE
City VENTNOR CITY
State NJ
ZIP 08406
Phone 609 823-0555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2025
Certificate Expiration Date 2/2/2027
Facility Type Physician Office
Lab Director MARK P. ALEXANDER

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