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31D2164906 CLIA NUMBER - PROFESSIONAL PHYSICIAN PRACTITIONERS

Laboratory Demographics

CLIA Number: 31D2164906

Facility Name: PROFESSIONAL PHYSICIAN PRACTITIONERS

Facility Address:
1576 LANES MILL ROAD
LAKEWOOD, NJ
ZIP 08701
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Facility Phone Number: 917 624-0222

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1255895751

Taxonomy: 207P00000X - Emergency Medicine
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

CLIA Record

Field Name Field Value
CLIA Number 31D2164906
LAB Type Physician Office
Facility Name PROFESSIONAL PHYSICIAN PRACTITIONERS
Street 1576 LANES MILL ROAD
City LAKEWOOD
State NJ
ZIP 08701
Phone 917 624-0222
CertificateType 4
CertificateEffectiveDate 4/16/2023
CertificateExpirationDate 4/15/2025
FacilityType Waiver

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