31D2061765 CLIA NUMBER - NEW JERSEY UROLOGY

Laboratory Demographics

  • CLIA Code: 31D2061765
  • Facility Name: NEW JERSEY UROLOGY
  • Facility Address: 1515 BROAD STREET SUITE B 140
    BLOOMFIELD, NJ
    ZIP 07003
  • Facility Phone: 973 873-7000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PATRICK CICCONE
  • NPI Number: 1588822423
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 31D2061765
LAB Type Physician Office
Facility Name NEW JERSEY UROLOGY
Street 1515 BROAD STREET SUITE B 140
City BLOOMFIELD
State NJ
ZIP 07003
Phone 973 873-7000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/26/2024
Certificate Expiration Date 12/25/2026
Facility Type Physician Office
Lab Director PATRICK CICCONE

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