Clinical Laboratory of NJ LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CLINICAL LABORATORY OF NJ LLC

Practice address

88 Pompton Ave
Verona, NJ 07044-2944

Phone

(973) 571-2000

Fax

(973) 571-2002

NPI assigned

Feb 10, 2020

Last updated

May 13, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Julius Ezomo

Title

Consultant

Phone

(973) 641-3114

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589328000000",
    "number": "1881226579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 POMPTON AVE",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070442944",
            "telephone_number": "973-571-2000",
            "fax_number": "973-571-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 POMPTON AVE",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070442944",
            "telephone_number": "973-571-2000",
            "fax_number": "973-571-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL LABORATORY OF NJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A",
        "authorized_official_last_name": "EZOMO",
        "authorized_official_first_name": "JULIUS",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "973-641-3114",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.comtronusa.com",
            "affiliation": "N",
            "address_1": "88 Pompton Ave",
            "city": "Verona",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070442944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Medical Laboratory in Verona, NJ
• Providers in Verona, NJ by specialty
• Clinical Medical Laboratory in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.