31D2132660 CLIA NUMBER - CANDLEWOOD PEDIATRICS - PRIMARY CARE PARTNERS AFFILIATE

Laboratory Demographics

  • CLIA Code: 31D2132660
  • Facility Name: CANDLEWOOD PEDIATRICS - PRIMARY CARE PARTNERS AFFILIATE
  • Facility Address: 1540 HIGHWAY 138 SUITE 105
    WALL, NJ
    ZIP 07719
  • Facility Phone: 732 280-3100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TATYANA SHROLNAYA
  • NPI Number: 1134545429
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 31D2132660
LAB Type Physician Office
Facility Name CANDLEWOOD PEDIATRICS - PRIMARY CARE PARTNERS AFFILIATE
Street 1540 HIGHWAY 138 SUITE 105
City WALL
State NJ
ZIP 07719
Phone 732 280-3100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/26/2025
Certificate Expiration Date 6/25/2027
Facility Type Physician Office
Lab Director TATYANA SHROLNAYA

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