31D2040315 CLIA NUMBER - OPTUM MEDICAL CARE OF NJ PC

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Laboratory Demographics

CLIA Number: 31D2040315

Facility Name: OPTUM MEDICAL CARE OF NJ PC

Facility Address:
324 PALISADES AVENUE, 2ND FL
JERSEY CITY, NJ
ZIP 07307
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Facility Phone Number: 201 386-1400

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1952849796

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	31D2040315
LAB Type	Physician Office
Facility Name	OPTUM MEDICAL CARE OF NJ PC
Street	324 PALISADES AVENUE, 2ND FL
City	JERSEY CITY
State	NJ
ZIP	07307
Phone	201 386-1400
CertificateType	4
CertificateEffectiveDate	4/27/2024
CertificateExpirationDate	4/26/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024