31D2312396 CLIA NUMBER - PREMIER BRAIN AND SPINE LLC

Laboratory Demographics

  • CLIA Code: 31D2312396
  • Facility Name: PREMIER BRAIN AND SPINE LLC
  • Facility Address: 3540 JOHN F KENNEDY BLVD 3RD FL
    JERSEY CITY, NJ
    ZIP 07307
  • Facility Phone: 551 345-4615
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. KUMUDINI MEHTA
  • NPI Number: 1922771377
  • Taxonomy: 207T00000X - Neurological Surgery

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CLIA Record

Field Name Field Value
CLIA Number 31D2312396
LAB Type Physician Office
Facility Name PREMIER BRAIN AND SPINE LLC
Street 3540 JOHN F KENNEDY BLVD 3RD FL
City JERSEY CITY
State NJ
ZIP 07307
Phone 551 345-4615
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2024
Certificate Expiration Date 10/9/2026
Facility Type Physician Office
Lab Director DR. KUMUDINI MEHTA

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