31D2256237 CLIA NUMBER - ADVANCED GENERAL MEDICINE

Laboratory Demographics

  • CLIA Code: 31D2256237
  • Facility Name: ADVANCED GENERAL MEDICINE
  • Facility Address: 1019 E JERSEY STREET
    ELIZABETH, NJ
    ZIP 07201
  • Facility Phone: 908 440-6395
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAUL E. VASQUEZ DURAN
  • NPI Number: 1609524941
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2256237
LAB Type Physician Office
Facility Name ADVANCED GENERAL MEDICINE
Street 1019 E JERSEY STREET
City ELIZABETH
State NJ
ZIP 07201
Phone 908 440-6395
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Physician Office
Lab Director RAUL E. VASQUEZ DURAN

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