31D2066248 CLIA NUMBER - PASSAIC PEDIATRICS II PA

Laboratory Demographics

  • CLIA Code: 31D2066248
  • Facility Name: PASSAIC PEDIATRICS II PA
  • Facility Address: 79 MARKET STREET
    PASSAIC, NJ
    ZIP 07055
  • Facility Phone: 862 238-8333
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARLO MICO
  • NPI Number: 1306240270
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 31D2066248
LAB Type Physician Office
Facility Name PASSAIC PEDIATRICS II PA
Street 79 MARKET STREET
City PASSAIC
State NJ
ZIP 07055
Phone 862 238-8333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2025
Certificate Expiration Date 9/23/2027
Facility Type Physician Office
Lab Director MARLO MICO

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