31D2140939 CLIA NUMBER - MEDWELL, LLC

Laboratory Demographics

  • CLIA Code: 31D2140939
  • Facility Name: MEDWELL, LLC
  • Facility Address: 33 CENTRAL AVENUE
    MIDLAND PARK, NJ
    ZIP 07432
  • Facility Phone: (201) 689-0800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MANOUCHEHR T. SHAHAB
  • NPI Number: 1659384360
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 31D2140939
LAB Type Physician Office
Facility Name MEDWELL, LLC
Street 33 CENTRAL AVENUE
City MIDLAND PARK
State NJ
ZIP 07432
Phone 2016890800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2026
Certificate Expiration Date 3/28/2028
Facility Type Physician Office
Lab Director MANOUCHEHR T. SHAHAB

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This page was last updated on: 5/18/2026