31D2309580 CLIA NUMBER - BASIC HOME INFUSION

Laboratory Demographics

  • CLIA Code: 31D2309580
  • Facility Name: BASIC HOME INFUSION
  • Facility Address: 1401 VALLEY ROAD FOURTH FLOOR
    WAYNE, NJ
    ZIP 07470
  • Facility Phone: 201 475-0500
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: JAYNA S. GULAN
  • NPI Number: 1679514509
  • Taxonomy: 3336H0001X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2309580
LAB Type Mobile Laboratory
Facility Name BASIC HOME INFUSION
Street 1401 VALLEY ROAD FOURTH FLOOR
City WAYNE
State NJ
ZIP 07470
Phone 201 475-0500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2024
Certificate Expiration Date 8/18/2026
Facility Type Mobile Laboratory
Lab Director JAYNA S. GULAN

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