31D1104820 CLIA NUMBER - ATLANTICARE PHYSICIAN GROUP OB/GYN EHT

Laboratory Demographics

  • CLIA Code: 31D1104820
  • Facility Name: ATLANTICARE PHYSICIAN GROUP OB/GYN EHT
  • Facility Address: 2500 ENGLISH CREEK AVE BLDG 1000 SUITE 1000
    EGG HARBOR TOWNSHIP, NJ
    ZIP 08234
  • Facility Phone: 609 833-9975
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BLAIR A. BERGEN
  • NPI Number: 1548419286
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 31D1104820
LAB Type Physician Office
Facility Name ATLANTICARE PHYSICIAN GROUP OB/GYN EHT
Street 2500 ENGLISH CREEK AVE BLDG 1000 SUITE 1000
City EGG HARBOR TOWNSHIP
State NJ
ZIP 08234
Phone 609 833-9975
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Physician Office
Lab Director BLAIR A. BERGEN

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