31D2076371 CLIA NUMBER - HACKENSACK MERIDIAN MEDICAL GROUP ENDOCRINOLOGIST

Laboratory Demographics

  • CLIA Code: 31D2076371
  • Facility Name: HACKENSACK MERIDIAN MEDICAL GROUP ENDOCRINOLOGIST
  • Facility Address: 6045 KENNEDY BOULEVARD, SUITE B
    NORTH BERGEN, NJ
    ZIP 07047
  • Facility Phone: 201 453-0322
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SONAL PATHAK
  • NPI Number: 1306864343
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 31D2076371
LAB Type Physician Office
Facility Name HACKENSACK MERIDIAN MEDICAL GROUP ENDOCRINOLOGIST
Street 6045 KENNEDY BOULEVARD, SUITE B
City NORTH BERGEN
State NJ
ZIP 07047
Phone 201 453-0322
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/17/2024
Certificate Expiration Date 4/16/2026
Facility Type Physician Office
Lab Director SONAL PATHAK

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