31D2062102 CLIA NUMBER - SHORE MEMORIAL PHYSICIANS GROUP PC

Laboratory Demographics

  • CLIA Code: 31D2062102
  • Facility Name: SHORE MEMORIAL PHYSICIANS GROUP PC
  • Facility Address: 4 ROOSEVELT BLVD
    MARMORA, NJ
    ZIP 08223
  • Facility Phone: 609 653-3500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHARLES V. ROCHE III
  • NPI Number: 1518252873
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D2062102
LAB Type Physician Office
Facility Name SHORE MEMORIAL PHYSICIANS GROUP PC
Street 4 ROOSEVELT BLVD
City MARMORA
State NJ
ZIP 08223
Phone 609 653-3500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2025
Certificate Expiration Date 7/9/2027
Facility Type Physician Office
Lab Director CHARLES V. ROCHE III

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