31D2195169 CLIA NUMBER - SUMMIT MEDICAL GROUP, PA DBA CITYMD

Laboratory Demographics

  • CLIA Code: 31D2195169
  • Facility Name: SUMMIT MEDICAL GROUP, PA DBA CITYMD
  • Facility Address: 60-66 FARM VIEW, BUILDING E
    MONTVALE, NJ
    ZIP 07645
  • Facility Phone: 551 497-5683
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL FROGEL
  • NPI Number: 1487228235
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2195169
LAB Type Physician Office
Facility Name SUMMIT MEDICAL GROUP, PA DBA CITYMD
Street 60-66 FARM VIEW, BUILDING E
City MONTVALE
State NJ
ZIP 07645
Phone 551 497-5683
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2024
Certificate Expiration Date 10/6/2026
Facility Type Physician Office
Lab Director DANIEL FROGEL

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