Healthcare Provider Details

I. General information

NPI: 1285540971
Provider Name (Legal Business Name): SUMMIT CLINICAL DIAGNOSTIC LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 US HIGHWAY 46 STE 160W
PARSIPPANY NJ
07054-2358
US

IV. Provider business mailing address

322 US HIGHWAY 46 STE 160W
PARSIPPANY NJ
07054-2358
US

V. Phone/Fax

Practice location:
  • Phone: 248-818-4925
  • Fax:
Mailing address:
  • Phone: 248-818-4925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ROBERT MANSI
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 248-818-4925