31D2029850 CLIA NUMBER - MT PROSPECT PHARMACEUTICAL SERVICES INC

Laboratory Demographics

  • CLIA Code: 31D2029850
  • Facility Name: MT PROSPECT PHARMACEUTICAL SERVICES INC
  • Facility Address: 794 MT PROSPECT AVE
    NEWARK, NJ
    ZIP 07104
  • Facility Phone: 973 483-4749
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RICHARD A. MISTICHELLI
  • NPI Number: 1083717482
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2029850
LAB Type Pharmacy
Facility Name MT PROSPECT PHARMACEUTICAL SERVICES INC
Street 794 MT PROSPECT AVE
City NEWARK
State NJ
ZIP 07104
Phone 973 483-4749
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/15/2025
Certificate Expiration Date 9/14/2027
Facility Type Pharmacy
Lab Director RICHARD A. MISTICHELLI

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