31D2115224 CLIA NUMBER - ROBERT COSTELLO, MD, LLC

Laboratory Demographics

  • CLIA Code: 31D2115224
  • Facility Name: ROBERT COSTELLO, MD, LLC
  • Facility Address: 220 HAMBURG TURNPIKE
    WAYNE, NJ
    ZIP 07470
  • Facility Phone: 973 942-5230
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT COSTELLO
  • NPI Number: 1326454638
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D2115224
LAB Type Physician Office
Facility Name ROBERT COSTELLO, MD, LLC
Street 220 HAMBURG TURNPIKE
City WAYNE
State NJ
ZIP 07470
Phone 973 942-5230
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2024
Certificate Expiration Date 6/29/2026
Facility Type Physician Office
Lab Director ROBERT COSTELLO

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