31D2074016 CLIA NUMBER - HEALTHY CHILD PEDIATRICS, LLC

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Laboratory Demographics

CLIA Number: 31D2074016

Facility Name: HEALTHY CHILD PEDIATRICS, LLC

Facility Address:
217 60TH STREET
WEST NEW YORK, NJ
ZIP 07093
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Facility Phone Number: 201 869-1108

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1861593261

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	31D2074016
LAB Type	Physician Office
Facility Name	HEALTHY CHILD PEDIATRICS, LLC
Street	217 60TH STREET
City	WEST NEW YORK
State	NJ
ZIP	07093
Phone	201 869-1108
CertificateType	4
CertificateEffectiveDate	2/27/2024
CertificateExpirationDate	2/26/2026
FacilityType	Waiver

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