31D2069270 CLIA NUMBER - LACEY MEDICAL GROUP, LLC

Laboratory Demographics

  • CLIA Code: 31D2069270
  • Facility Name: LACEY MEDICAL GROUP, LLC
  • Facility Address: 1044 LACEY ROAD BLDG B STE 9
    FORKED RIVER, NJ
    ZIP 08731
  • Facility Phone: 609 693-0819
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANN DIPAOLO
  • NPI Number: 1487091369
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 31D2069270
LAB Type Physician Office
Facility Name LACEY MEDICAL GROUP, LLC
Street 1044 LACEY ROAD BLDG B STE 9
City FORKED RIVER
State NJ
ZIP 08731
Phone 609 693-0819
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2023
Certificate Expiration Date 11/19/2025
Facility Type Physician Office
Lab Director ANN DIPAOLO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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