31D2033765 CLIA NUMBER - VIRTUA RECONSTRUCTIVE ORTHOPEDICS - MEDFORD

Laboratory Demographics

  • CLIA Code: 31D2033765
  • Facility Name: VIRTUA RECONSTRUCTIVE ORTHOPEDICS - MEDFORD
  • Facility Address: 11 RT 70 W SUITE 100
    MEDFORD, NJ
    ZIP 08055
  • Facility Phone: 856 673-3960
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GABRIELLA GUTMAN
  • NPI Number: 1124526421
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 31D2033765
LAB Type Physician Office
Facility Name VIRTUA RECONSTRUCTIVE ORTHOPEDICS - MEDFORD
Street 11 RT 70 W SUITE 100
City MEDFORD
State NJ
ZIP 08055
Phone 856 673-3960
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2023
Certificate Expiration Date 12/8/2025
Facility Type Physician Office
Lab Director GABRIELLA GUTMAN

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