31D2064544 CLIA NUMBER - MEJIA PEDIATRICS LLC

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Laboratory Demographics

CLIA Number: 31D2064544

Facility Name: MEJIA PEDIATRICS LLC

Facility Address:
433 NORTH BROAD STREET
ELIZABETH, NJ
ZIP 07208
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Facility Phone Number: 908 436-1002

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1043507270

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D2064544
LAB Type	Physician Office
Facility Name	MEJIA PEDIATRICS LLC
Street	433 NORTH BROAD STREET
City	ELIZABETH
State	NJ
ZIP	07208
Phone	908 436-1002
CertificateType	4
CertificateEffectiveDate	8/21/2023
CertificateExpirationDate	8/20/2025
FacilityType	Waiver

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