31D1096460 CLIA NUMBER - MAPLEWOOD FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 31D1096460
  • Facility Name: MAPLEWOOD FAMILY MEDICINE
  • Facility Address: 111 DUNNELL ROAD, SUITE 200
    MAPLEWOOD, NJ
    ZIP 07040
  • Facility Phone: 908 598-6690
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRSITINA JOHNSON
  • NPI Number: 1649880022
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 31D1096460
LAB Type Physician Office
Facility Name MAPLEWOOD FAMILY MEDICINE
Street 111 DUNNELL ROAD, SUITE 200
City MAPLEWOOD
State NJ
ZIP 07040
Phone 908 598-6690
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2025
Certificate Expiration Date 3/4/2027
Facility Type Physician Office
Lab Director CHRSITINA JOHNSON

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