31D2094946 CLIA NUMBER - JERSEY CITY GRAND HOME DIALYSIS

Laboratory Demographics

  • CLIA Code: 31D2094946
  • Facility Name: JERSEY CITY GRAND HOME DIALYSIS
  • Facility Address: 422 GRAND AVENUE
    JERSEY CITY, NJ
    ZIP 07302
  • Facility Phone: 201 332-6413
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SONIA C. SIMOES
  • NPI Number: 1619361136
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2094946
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name JERSEY CITY GRAND HOME DIALYSIS
Street 422 GRAND AVENUE
City JERSEY CITY
State NJ
ZIP 07302
Phone 201 332-6413
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SONIA C. SIMOES

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