31D2126608 CLIA NUMBER - ENTERPRISE ALLIANCE GROUP DBA INTERVENTION SPECIALIST

Laboratory Demographics

  • CLIA Code: 31D2126608
  • Facility Name: ENTERPRISE ALLIANCE GROUP DBA INTERVENTION SPECIALIST
  • Facility Address: 333 NORTH BROAD STREET, SUITE 2B
    ELIZABETH, NJ
    ZIP 07208
  • Facility Phone: 908 289-0700
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: ANGELICA ALLSICH
  • NPI Number: 1619740107
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2126608
LAB Type Independent
Facility Name ENTERPRISE ALLIANCE GROUP DBA INTERVENTION SPECIALIST
Street 333 NORTH BROAD STREET, SUITE 2B
City ELIZABETH
State NJ
ZIP 07208
Phone 908 289-0700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/29/2024
Certificate Expiration Date 1/28/2026
Facility Type Independent
Lab Director ANGELICA ALLSICH

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