31D2301646 CLIA NUMBER - SOUTH ORANGE OBGYN & INFERTILITY GROUP

Laboratory Demographics

CLIA Number: 31D2301646

Facility Name: SOUTH ORANGE OBGYN & INFERTILITY GROUP

Facility Address:
106 VALLEY STREET
SOUTH ORANGE, NJ
ZIP 07079
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Facility Phone Number: 973 763-4334

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1629244512

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	31D2301646
LAB Type	Physician Office
Facility Name	SOUTH ORANGE OBGYN & INFERTILITY GROUP
Street	106 VALLEY STREET
City	SOUTH ORANGE
State	NJ
ZIP	07079
Phone	973 763-4334
CertificateType	4
CertificateEffectiveDate	3/28/2024
CertificateExpirationDate	3/27/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024