31D2250327 CLIA NUMBER - UNITED CLINICAL GROUP NJ

Laboratory Demographics

  • CLIA Code: 31D2250327
  • Facility Name: UNITED CLINICAL GROUP NJ
  • Facility Address: 1083 GOFFLE ROAD
    HAWTHORNE, NJ
    ZIP 07506
  • Facility Phone: 877 328-7112
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ENAS TUPPO
  • NPI Number: 1831801083
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 31D2250327
LAB Type Physician Office
Facility Name UNITED CLINICAL GROUP NJ
Street 1083 GOFFLE ROAD
City HAWTHORNE
State NJ
ZIP 07506
Phone 877 328-7112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Physician Office
Lab Director ENAS TUPPO

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