31D2178413 CLIA NUMBER - PEDIATRICS ON BROADWAY

Laboratory Demographics

  • CLIA Code: 31D2178413
  • Facility Name: PEDIATRICS ON BROADWAY
  • Facility Address: 10 BROADWAY
    DENVILLE, NJ
    ZIP 07834
  • Facility Phone: 856 782-3300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD DICKER
  • NPI Number: 1497709661
  • Taxonomy: 2080P0203X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 31D2178413
LAB Type Physician Office
Facility Name PEDIATRICS ON BROADWAY
Street 10 BROADWAY
City DENVILLE
State NJ
ZIP 07834
Phone 856 782-3300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2024
Certificate Expiration Date 2/2/2026
Facility Type Physician Office
Lab Director RICHARD DICKER

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