31D2158595 CLIA NUMBER - PRIME ENDOCRINOLOGY

Laboratory Demographics

  • CLIA Code: 31D2158595
  • Facility Name: PRIME ENDOCRINOLOGY
  • Facility Address: 103 PARKER ROAD, SUITE B
    WEST LONG BRANCH, NJ
    ZIP 07764
  • Facility Phone: 732 222-0307
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUDHA GANNE
  • NPI Number: 1306312095
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2158595
LAB Type Physician Office
Facility Name PRIME ENDOCRINOLOGY
Street 103 PARKER ROAD, SUITE B
City WEST LONG BRANCH
State NJ
ZIP 07764
Phone 732 222-0307
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2024
Certificate Expiration Date 12/2/2026
Facility Type Physician Office
Lab Director SUDHA GANNE

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