31D2061781 CLIA NUMBER - NORTHERN NEW JERSEY EYE INSTITUTE PA

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Laboratory Demographics

CLIA Number: 31D2061781

Facility Name: NORTHERN NEW JERSEY EYE INSTITUTE PA

Facility Address:
71 SECOND STREET
SOUTH ORANGE, NJ
ZIP 07079
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Facility Phone Number: 973 763-2203

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1033294640

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D2061781
LAB Type	Ambulatory Surgery Center
Facility Name	NORTHERN NEW JERSEY EYE INSTITUTE PA
Street	71 SECOND STREET
City	SOUTH ORANGE
State	NJ
ZIP	07079
Phone	973 763-2203
CertificateType	4
CertificateEffectiveDate	7/3/2023
CertificateExpirationDate	7/2/2025
FacilityType	Waiver

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