31D2270261 CLIA NUMBER - CRESCENT MEDICAL GROUP PC

Laboratory Demographics

  • CLIA Code: 31D2270261
  • Facility Name: CRESCENT MEDICAL GROUP PC
  • Facility Address: 141 CHESTNUT ST STE 202
    ROSELLE PARK, NJ
    ZIP 07204
  • Facility Phone: 908 280-9600
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: SEKULEO GATHERS
  • NPI Number: 1487348306
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 31D2270261
LAB Type Other - URGENT CARE
Facility Name CRESCENT MEDICAL GROUP PC
Street 141 CHESTNUT ST STE 202
City ROSELLE PARK
State NJ
ZIP 07204
Phone 908 280-9600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2024
Certificate Expiration Date 10/11/2026
Facility Type Other - URGENT CARE
Lab Director SEKULEO GATHERS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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