31D2023866 CLIA NUMBER - COLLEGE PLAZA PEDIATRICS

Laboratory Demographics

  • CLIA Code: 31D2023866
  • Facility Name: COLLEGE PLAZA PEDIATRICS
  • Facility Address: 765 ROUTE 10 EAST STE 203
    RANDOLPH, NJ
    ZIP 07869
  • Facility Phone: 973 659-9991
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JULIO GUERRA
  • NPI Number: 1417083403
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 31D2023866
LAB Type Physician Office
Facility Name COLLEGE PLAZA PEDIATRICS
Street 765 ROUTE 10 EAST STE 203
City RANDOLPH
State NJ
ZIP 07869
Phone 973 659-9991
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Physician Office
Lab Director JULIO GUERRA

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