31D2050272 CLIA NUMBER - PARK AVENUE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 31D2050272
  • Facility Name: PARK AVENUE MEDICAL CENTER
  • Facility Address: 535 GETTY AVENUE, SUITE 3
    CLIFTON, NJ
    ZIP 07011
  • Facility Phone: 973 782-4905
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAFATH K. HUMERA
  • NPI Number: 1447533773
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D2050272
LAB Type Physician Office
Facility Name PARK AVENUE MEDICAL CENTER
Street 535 GETTY AVENUE, SUITE 3
City CLIFTON
State NJ
ZIP 07011
Phone 973 782-4905
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/26/2024
Certificate Expiration Date 11/25/2026
Facility Type Physician Office
Lab Director RAFATH K. HUMERA

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