31D2182796 CLIA NUMBER - HACKENSACK UNIVERSITY MEDICAL GROUP PC

Laboratory Demographics

  • CLIA Code: 31D2182796
  • Facility Name: HACKENSACK UNIVERSITY MEDICAL GROUP PC
  • Facility Address: 160 ESSEX STREET, SUITE 103
    LODI, NJ
    ZIP 07644
  • Facility Phone: 551 996-1378
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EMANUELE SANTOMAURO
  • NPI Number: 1215437553
  • Taxonomy: 3336H0001X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2182796
LAB Type Physician Office
Facility Name HACKENSACK UNIVERSITY MEDICAL GROUP PC
Street 160 ESSEX STREET, SUITE 103
City LODI
State NJ
ZIP 07644
Phone 551 996-1378
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2024
Certificate Expiration Date 4/26/2026
Facility Type Physician Office
Lab Director EMANUELE SANTOMAURO

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