31D2068336 CLIA NUMBER - AVENUE PEDIATRICS

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Laboratory Demographics

CLIA Number: 31D2068336

Facility Name: AVENUE PEDIATRICS

Facility Address:
1140 BLOOMFIELD AVENUE, SUITE 213
WEST CALDWELL, NJ
ZIP 07006
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Facility Phone Number: 973 228-6302

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1265859094

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name	Field Value
CLIA Number	31D2068336
LAB Type	Physician Office
Facility Name	AVENUE PEDIATRICS
Street	1140 BLOOMFIELD AVENUE, SUITE 213
City	WEST CALDWELL
State	NJ
ZIP	07006
Phone	973 228-6302
CertificateType	4
CertificateEffectiveDate	6/14/2022
CertificateExpirationDate	6/13/2024
FacilityType	Waiver

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