31D2203662 CLIA NUMBER - HACKENSACK MERIDIAN HEALTH MEDICAL GROUP SPECIALTY CARE, PC

Laboratory Demographics

  • CLIA Code: 31D2203662
  • Facility Name: HACKENSACK MERIDIAN HEALTH MEDICAL GROUP SPECIALTY CARE, PC
  • Facility Address: 385 PROSPECT AVE SUITE 306
    HACKENSACK, NJ
    ZIP 07601
  • Facility Phone: 201 342-5360
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: COLETTE M. KNIGHT
  • NPI Number: 1598543167
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 31D2203662
LAB Type Physician Office
Facility Name HACKENSACK MERIDIAN HEALTH MEDICAL GROUP SPECIALTY CARE, PC
Street 385 PROSPECT AVE SUITE 306
City HACKENSACK
State NJ
ZIP 07601
Phone 201 342-5360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2024
Certificate Expiration Date 12/3/2026
Facility Type Physician Office
Lab Director COLETTE M. KNIGHT

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