31D2056772 CLIA NUMBER - APOLLO MEDICAL GROUP PA

Laboratory Demographics

  • CLIA Code: 31D2056772
  • Facility Name: APOLLO MEDICAL GROUP PA
  • Facility Address: 49 BRANT AVENUE
    CLARK, NJ
    ZIP 07066
  • Facility Phone: 908 753-2662
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAO V. VINNAKOTA
  • NPI Number: 1568623296
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 31D2056772
LAB Type Physician Office
Facility Name APOLLO MEDICAL GROUP PA
Street 49 BRANT AVENUE
City CLARK
State NJ
ZIP 07066
Phone 908 753-2662
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2025
Certificate Expiration Date 4/2/2027
Facility Type Physician Office
Lab Director RAO V. VINNAKOTA

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