31D2188677 CLIA NUMBER - SUNNYSIDE MANOR

Laboratory Demographics

  • CLIA Code: 31D2188677
  • Facility Name: SUNNYSIDE MANOR
  • Facility Address: 2500 RIDGEWOOD ROAD
    WALL, NJ
    ZIP 07719
  • Facility Phone: 732 528-9311
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ROBERT DEMARTIN
  • NPI Number: 1417093501
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 31D2188677
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SUNNYSIDE MANOR
Street 2500 RIDGEWOOD ROAD
City WALL
State NJ
ZIP 07719
Phone 732 528-9311
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2024
Certificate Expiration Date 7/20/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ROBERT DEMARTIN

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