31D2208009 CLIA NUMBER - SUMMIT MEDICAL GROUP PA DBA SUMMIT HEALTH

Laboratory Demographics

  • CLIA Code: 31D2208009
  • Facility Name: SUMMIT MEDICAL GROUP PA DBA SUMMIT HEALTH
  • Facility Address: 17-17 ROUTE 208
    FAIR LAWN, NJ
    ZIP 07410
  • Facility Phone: 201 693-4051
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACK CAPPITELLI
  • NPI Number: 1255051959
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 31D2208009
LAB Type Physician Office
Facility Name SUMMIT MEDICAL GROUP PA DBA SUMMIT HEALTH
Street 17-17 ROUTE 208
City FAIR LAWN
State NJ
ZIP 07410
Phone 201 693-4051
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2025
Certificate Expiration Date 1/3/2027
Facility Type Physician Office
Lab Director JACK CAPPITELLI

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