31D2158611 CLIA NUMBER - PHYSICIAN'S WEIGHTLOSS PC

Laboratory Demographics

CLIA Number: 31D2158611

Facility Name: PHYSICIAN'S WEIGHTLOSS PC

Facility Address:
326 US 22, SUITE 10B
GREEN BROOK, NJ
ZIP 08812
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Facility Phone Number: 732 624-9797

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1760948012

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	31D2158611
LAB Type	Physician Office
Facility Name	PHYSICIAN'S WEIGHTLOSS PC
Street	326 US 22, SUITE 10B
City	GREEN BROOK
State	NJ
ZIP	08812
Phone	732 624-9797
CertificateType	4
CertificateEffectiveDate	12/3/2022
CertificateExpirationDate	12/2/2024
FacilityType	Waiver

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