31D1057284 CLIA NUMBER - SURGICAL CENTER AT CEDAR KNOLLS LLC

Laboratory Demographics

  • CLIA Code: 31D1057284
  • Facility Name: SURGICAL CENTER AT CEDAR KNOLLS LLC
  • Facility Address: 197 RIDGEDALE AVENUE, SUITE 100
    CEDAR KNOLLS, NJ
    ZIP 07927
  • Facility Phone: 973 945-7558
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KENNETH MONTGOMERY
  • NPI Number: 1528104080
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D1057284
LAB Type Ambulatory Surgery Center
Facility Name SURGICAL CENTER AT CEDAR KNOLLS LLC
Street 197 RIDGEDALE AVENUE, SUITE 100
City CEDAR KNOLLS
State NJ
ZIP 07927
Phone 973 945-7558
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2024
Certificate Expiration Date 8/7/2026
Facility Type Ambulatory Surgery Center
Lab Director KENNETH MONTGOMERY

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This page was last updated on: 3/20/2025