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31D2081467 CLIA NUMBER - GERIATRICS AND LONGEVITY TREATMENT SPECIALIST, PC

Laboratory Demographics

CLIA Number: 31D2081467

Facility Name: GERIATRICS AND LONGEVITY TREATMENT SPECIALIST, PC

Facility Address:
810 MAIN STREET
HACKENSACK, NJ
ZIP 07601
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Facility Phone Number: 201 488-6728

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1023503075

Taxonomy: 253Z00000X - In Home Supportive Care
An In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves.

CLIA Record

Field Name Field Value
CLIA Number 31D2081467
LAB Type Physician Office
Facility Name GERIATRICS AND LONGEVITY TREATMENT SPECIALIST, PC
Street 810 MAIN STREET
City HACKENSACK
State NJ
ZIP 07601
Phone 201 488-6728
CertificateType 4
CertificateEffectiveDate 7/25/2022
CertificateExpirationDate 7/24/2024
FacilityType Waiver

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