31D2057559 CLIA NUMBER - MID STATE GASTROENTEROLOGY, LLC

Home > CLIA Lookup > 31D2057559

Laboratory Demographics

CLIA Number: 31D2057559

Facility Name: MID STATE GASTROENTEROLOGY, LLC

Facility Address:
800 WEST MAIN ST SUITE 111
FREEHOLD, NJ
ZIP 07728
Get Directions

Facility Phone Number: 732 303-3888

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1235472424

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	31D2057559
LAB Type	Physician Office
Facility Name	MID STATE GASTROENTEROLOGY, LLC
Street	800 WEST MAIN ST SUITE 111
City	FREEHOLD
State	NJ
ZIP	07728
Phone	732 303-3888
CertificateType	4
CertificateEffectiveDate	4/18/2023
CertificateExpirationDate	4/17/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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