31D2038492 CLIA NUMBER - COASTAL SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 31D2038492
  • Facility Name: COASTAL SURGERY CENTER, LLC
  • Facility Address: 3700 ROUTE 33 LL01
    NEPTUNE, NJ
    ZIP 07753
  • Facility Phone: 732 280-7855
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARY T. MITSKAVICH
  • NPI Number: 1316219470
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2038492
LAB Type Ambulatory Surgery Center
Facility Name COASTAL SURGERY CENTER, LLC
Street 3700 ROUTE 33 LL01
City NEPTUNE
State NJ
ZIP 07753
Phone 732 280-7855
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2024
Certificate Expiration Date 3/20/2026
Facility Type Ambulatory Surgery Center
Lab Director MARY T. MITSKAVICH

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