31D2176040 CLIA NUMBER - JACEK GRZYBOWSKI, MD, LLC

Laboratory Demographics

  • CLIA Code: 31D2176040
  • Facility Name: JACEK GRZYBOWSKI, MD, LLC
  • Facility Address: 812 N WOOD AVENUE, SUITE 204
    LINDEN, NJ
    ZIP 07036
  • Facility Phone: 908 587-9611
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACEK GRZYBOWSKI
  • NPI Number: 1225038508
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 31D2176040
LAB Type Physician Office
Facility Name JACEK GRZYBOWSKI, MD, LLC
Street 812 N WOOD AVENUE, SUITE 204
City LINDEN
State NJ
ZIP 07036
Phone 908 587-9611
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2023
Certificate Expiration Date 12/5/2025
Facility Type Physician Office
Lab Director JACEK GRZYBOWSKI

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