31D1101685 CLIA NUMBER - SUMMIT MEDICAL GROUP, PA

Laboratory Demographics

  • CLIA Code: 31D1101685
  • Facility Name: SUMMIT MEDICAL GROUP, PA
  • Facility Address: 1500 PLEASANT VALLEY WAY
    WEST ORANGE, NJ
    ZIP 07052
  • Facility Phone: 908 312-9107
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHETAL MANSURIA
  • NPI Number: 1245950799
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 31D1101685
LAB Type Physician Office
Facility Name SUMMIT MEDICAL GROUP, PA
Street 1500 PLEASANT VALLEY WAY
City WEST ORANGE
State NJ
ZIP 07052
Phone 908 312-9107
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2024
Certificate Expiration Date 9/22/2026
Facility Type Physician Office
Lab Director SHETAL MANSURIA

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