31D2064546 CLIA NUMBER - TRI-STATE SURGERY CENTER

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Laboratory Demographics

CLIA Number: 31D2064546

Facility Name: TRI-STATE SURGERY CENTER

Facility Address:
3 WINSLOW PLACE
PARAMUS, NJ
ZIP 07652
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Facility Phone Number: 201 546-1890

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1669612990

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D2064546
LAB Type	Ambulatory Surgery Center
Facility Name	TRI-STATE SURGERY CENTER
Street	3 WINSLOW PLACE
City	PARAMUS
State	NJ
ZIP	07652
Phone	201 546-1890
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