31D2069557 CLIA NUMBER - ADVOCARE PROGRESSIVE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 31D2069557
  • Facility Name: ADVOCARE PROGRESSIVE PEDIATRICS
  • Facility Address: 1222 KENNEDY BOULEVARD
    BAYONNE, NJ
    ZIP 07002
  • Facility Phone: 201 319-9800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NOHA POLACK
  • NPI Number: 1487129680
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 31D2069557
LAB Type Physician Office
Facility Name ADVOCARE PROGRESSIVE PEDIATRICS
Street 1222 KENNEDY BOULEVARD
City BAYONNE
State NJ
ZIP 07002
Phone 201 319-9800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2025
Certificate Expiration Date 1/3/2027
Facility Type Physician Office
Lab Director NOHA POLACK

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