31D2319276 CLIA NUMBER - CORE OUTPATIENT SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 31D2319276
  • Facility Name: CORE OUTPATIENT SERVICES, LLC
  • Facility Address: 540 BORDENTOWN AVE SUITE 203
    SOUTH AMBOY, NJ
    ZIP 08879
  • Facility Phone: 732 963-2626
  • Facility Type: Other - IOP AND OP
  • Facility Type: Waiver
  • Lab Director: KELLY COPPOLA
  • NPI Number: 1518527969
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2319276
LAB Type Other - IOP AND OP
Facility Name CORE OUTPATIENT SERVICES, LLC
Street 540 BORDENTOWN AVE SUITE 203
City SOUTH AMBOY
State NJ
ZIP 08879
Phone 732 963-2626
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2025
Certificate Expiration Date 2/25/2027
Facility Type Other - IOP AND OP
Lab Director KELLY COPPOLA

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