31D2094278 CLIA NUMBER - IMAGE DERMATOLOGY, PC

Laboratory Demographics

  • CLIA Code: 31D2094278
  • Facility Name: IMAGE DERMATOLOGY, PC
  • Facility Address: 51 PARK STREET
    MONTCLAIR, NJ
    ZIP 07042
  • Facility Phone: 973 509-6900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEANINE B. DOWNIE
  • NPI Number: 1104027556
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 31D2094278
LAB Type Physician Office
Facility Name IMAGE DERMATOLOGY, PC
Street 51 PARK STREET
City MONTCLAIR
State NJ
ZIP 07042
Phone 973 509-6900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Physician Office
Lab Director JEANINE B. DOWNIE

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