31D2154900 CLIA NUMBER - CENTER FOR UROGYNECOLOGY AND RECONSTRUCTIVE PELVIC SURGERY

Laboratory Demographics

  • CLIA Code: 31D2154900
  • Facility Name: CENTER FOR UROGYNECOLOGY AND RECONSTRUCTIVE PELVIC SURGERY
  • Facility Address: 1 ROUTE 70 WEST
    LAKEWOOD, NJ
    ZIP 08701
  • Facility Phone: 732 372-0399
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MANISG GOPAL
  • NPI Number: 1225258403
  • Taxonomy: 235Z00000X - Speech-Language Pathologist

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CLIA Record

Field Name Field Value
CLIA Number 31D2154900
LAB Type Physician Office
Facility Name CENTER FOR UROGYNECOLOGY AND RECONSTRUCTIVE PELVIC SURGERY
Street 1 ROUTE 70 WEST
City LAKEWOOD
State NJ
ZIP 08701
Phone 732 372-0399
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Physician Office
Lab Director MANISG GOPAL

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