31D2063113 CLIA NUMBER - GLEN ROCK PEDIATRICS

Laboratory Demographics

  • CLIA Code: 31D2063113
  • Facility Name: GLEN ROCK PEDIATRICS
  • Facility Address: 385 SOUTH MAPLE AVENUE SUITE 107
    GLEN ROCK, NJ
    ZIP 07452
  • Facility Phone: 201 857-3111
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DORINA HALIFMAN
  • NPI Number: 1750752135
  • Taxonomy: 173000000X - Legal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D2063113
LAB Type Physician Office
Facility Name GLEN ROCK PEDIATRICS
Street 385 SOUTH MAPLE AVENUE SUITE 107
City GLEN ROCK
State NJ
ZIP 07452
Phone 201 857-3111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/26/2025
Certificate Expiration Date 7/25/2027
Facility Type Physician Office
Lab Director DORINA HALIFMAN

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