31D2149450 CLIA NUMBER - SOUTH JERSEY EYE PHYSICIANS, PA

Laboratory Demographics

CLIA Number: 31D2149450

Facility Name: SOUTH JERSEY EYE PHYSICIANS, PA

Facility Address:
103 OLD MARLTON PIKE, SUITE 216
MEDFORD, NJ
ZIP 08055
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Facility Phone Number: 856 231-5907

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1497101430

Taxonomy: 261QD0000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D2149450
LAB Type	Physician Office
Facility Name	SOUTH JERSEY EYE PHYSICIANS, PA
Street	103 OLD MARLTON PIKE, SUITE 216
City	MEDFORD
State	NJ
ZIP	08055
Phone	856 231-5907
CertificateType	4
CertificateEffectiveDate	6/5/2022
CertificateExpirationDate	6/4/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024