31D2026431 CLIA NUMBER - EASTERN VASCULAR ASSOCIATES PRIMARY CARE PARTNER AFFILIATE

Laboratory Demographics

  • CLIA Code: 31D2026431
  • Facility Name: EASTERN VASCULAR ASSOCIATES PRIMARY CARE PARTNER AFFILIATE
  • Facility Address: 16 POCONO ROAD SUITE 313
    DENVILLE, NJ
    ZIP 07834
  • Facility Phone: (973) 625-0112
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRUCE L. MINTZ
  • NPI Number: 1609960418
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D2026431
LAB Type Physician Office
Facility Name EASTERN VASCULAR ASSOCIATES PRIMARY CARE PARTNER AFFILIATE
Street 16 POCONO ROAD SUITE 313
City DENVILLE
State NJ
ZIP 07834
Phone 9736250112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2025
Certificate Expiration Date 6/29/2027
Facility Type Physician Office
Lab Director BRUCE L. MINTZ

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This page was last updated on: 5/18/2026