31D2220079 CLIA NUMBER - MUJTABA NP WALK IN CLINIC PROFESSIONAL CORPORATION

Laboratory Demographics

  • CLIA Code: 31D2220079
  • Facility Name: MUJTABA NP WALK IN CLINIC PROFESSIONAL CORPORATION
  • Facility Address: 859 CLIFTON AVE, SUITE H
    CLIFTON, NJ
    ZIP 07013
  • Facility Phone: 516 974-7434
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASSAD MUJTABA
  • NPI Number: 1629669775
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 31D2220079
LAB Type Physician Office
Facility Name MUJTABA NP WALK IN CLINIC PROFESSIONAL CORPORATION
Street 859 CLIFTON AVE, SUITE H
City CLIFTON
State NJ
ZIP 07013
Phone 516 974-7434
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/9/2023
Certificate Expiration Date 4/8/2025
Facility Type Physician Office
Lab Director ASSAD MUJTABA

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This page was last updated on: 3/20/2025