31D2100662 CLIA NUMBER - SENIOR HEALTHCARE OUTREACH PROGRAM

Laboratory Demographics

  • CLIA Code: 31D2100662
  • Facility Name: SENIOR HEALTHCARE OUTREACH PROGRAM
  • Facility Address: 613 PARK AVENUE
    EAST ORANGE, NJ
    ZIP 07017
  • Facility Phone: 973 676-0955
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALEXANDER G. SALERNO
  • NPI Number: 1588707954
  • Taxonomy: 207RG0300X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 31D2100662
LAB Type Physician Office
Facility Name SENIOR HEALTHCARE OUTREACH PROGRAM
Street 613 PARK AVENUE
City EAST ORANGE
State NJ
ZIP 07017
Phone 973 676-0955
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2025
Certificate Expiration Date 8/18/2027
Facility Type Physician Office
Lab Director ALEXANDER G. SALERNO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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