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

Laboratory Demographics

  • CLIA Code: 31D2081467
  • Facility Name: GERIATRICS AND LONGEVITY TREATMENT SPECIALIST, PC
  • Facility Address: 810 MAIN STREET
    HACKENSACK, NJ
    ZIP 07601
  • Facility Phone: 201 488-6728
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEFANOS G. PANTAGIS
  • NPI Number: 1023503075
  • Taxonomy: 253Z00000X - In Home Supportive Care

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/25/2024
Certificate Expiration Date 7/24/2026
Facility Type Physician Office
Lab Director STEFANOS G. PANTAGIS

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