31D2111044 CLIA NUMBER - HAWTHORNE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 31D2111044
  • Facility Name: HAWTHORNE PEDIATRICS
  • Facility Address: 330 LAFAYETTE AVENUE
    HAWTHORNE, NJ
    ZIP 07506
  • Facility Phone: 973 841-5112
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARIA J. VASENA MARENGO
  • NPI Number: 1336525260
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2111044
LAB Type Physician Office
Facility Name HAWTHORNE PEDIATRICS
Street 330 LAFAYETTE AVENUE
City HAWTHORNE
State NJ
ZIP 07506
Phone 973 841-5112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2024
Certificate Expiration Date 3/29/2026
Facility Type Physician Office
Lab Director MARIA J. VASENA MARENGO

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