31D2093197 CLIA NUMBER - MERIDIAN MEDICAL GROUP PRIMARY CARE PC

Laboratory Demographics

  • CLIA Code: 31D2093197
  • Facility Name: MERIDIAN MEDICAL GROUP PRIMARY CARE PC
  • Facility Address: 501 ROUTE 9 SOUTH 1ST FLOOR SUITE 240
    WARETOWN, NJ
    ZIP 08758
  • Facility Phone: 609 693-1992
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THEODORE ENDE
  • NPI Number: 1699163527
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 31D2093197
LAB Type Physician Office
Facility Name MERIDIAN MEDICAL GROUP PRIMARY CARE PC
Street 501 ROUTE 9 SOUTH 1ST FLOOR SUITE 240
City WARETOWN
State NJ
ZIP 08758
Phone 609 693-1992
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Physician Office
Lab Director THEODORE ENDE

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