31D2292753 CLIA NUMBER - EHPN-ADDICTION MEDICINE

Laboratory Demographics

  • CLIA Code: 31D2292753
  • Facility Name: EHPN-ADDICTION MEDICINE
  • Facility Address: 286 ENGLE STREET
    ENGLEWOOD, NJ
    ZIP 07631
  • Facility Phone: 201 567-5636
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHARDE MCLEISH
  • NPI Number: 1053366054
  • Taxonomy: 207ZP0102X - Pathology

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CLIA Record

Field Name Field Value
CLIA Number 31D2292753
LAB Type Physician Office
Facility Name EHPN-ADDICTION MEDICINE
Street 286 ENGLE STREET
City ENGLEWOOD
State NJ
ZIP 07631
Phone 201 567-5636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2023
Certificate Expiration Date 10/29/2025
Facility Type Physician Office
Lab Director SHARDE MCLEISH

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