PREMISE HEALTH OF NEW JERSEY MEDICAL, P.C.
NPI 1396454765
Clinic/Center - Multi-Specialty in Newark, NJ

Q: What is Premise Health Of New Jersey Medical, P.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Active since November 15, 2022CLIA Certified · 2 labs

390 E PORT ST, NEWARK, NJ 07114(615) 468-3188 Get Directions Write a Review

NPPES record last updated: November 15, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Premise Health Of New Jersey Medical, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMISE HEALTH OF NEW JERSEY MEDICAL, P.C. (NPI 1396454765), doing business as Tls Newark Health Center, is a healthcare organization registered as a multi-specialty in Newark, New Jersey and active in the NPI registry since November 2022. The organization holds 2 active CLIA laboratory certificates and lists William Wright, Legal Counsel, as its authorized official.

NPPES Registry Identity

NPI1396454765

Entity TypeOrganization

Primary Taxonomy261QM1300X

Legal Business NamePREMISE HEALTH OF NEW JERSEY MEDICAL, P.C.

Location Address390 E PORT STNewark, NJ 07114-3115

Mailing Address5500 Maryland Way Ste 120Brentwood, TN 37027-4993

Phone(615) 468-3188

Organization SubpartNo

Authorized OfficialWilliam WrightLegal Counsel · (615) 577-5893

Enumeration DateNovember 15, 2022

NPPES CertifiedNovember 15, 2022

✔ NPI 1396454765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM1300X

390 E PORT ST, Newark, NJ 07114

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Other Names 1

Doing Business AsTls Newark Health Center

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D2272334

Premise Health Of New Jersey Medical PC · Newark, NJ

Active · expires Nov 17, 2026

CLIA Number31D2272334

Laboratory TypePhysician Office

Certificate Effective DateNovember 18, 2024

Certificate Expiration DateNovember 17, 2026

Laboratory DirectorMario Del Valle

Laboratory Phone(973) 274-2792

Laboratory LocationPremise Health Of New Jersey Medical PC390 E Port Street, Newark, NJ 07114

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 31D0955054

Premise Health Of New Jersey Medical, PC · Newark, NJ

Active · expires Dec 15, 2026

CLIA Number31D0955054

Laboratory TypeIndustrial

Certificate Effective DateDecember 16, 2024

Certificate Expiration DateDecember 15, 2026

Laboratory DirectorDarmadi Khong

Laboratory Phone(973) 861-0200

Laboratory LocationPremise Health Of New Jersey Medical, PCTerm C Continental Airlines Rm 136, Newark, NJ 07114

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premise Health Of New Jersey Medical, P.C.'s NPI number?

The NPI number for Premise Health Of New Jersey Medical, P.C. is 1396454765. It was assigned to this organization in the NPPES registry on November 15, 2022.

Where is Premise Health Of New Jersey Medical, P.C. located?

Premise Health Of New Jersey Medical, P.C. is located at 390 E Port St, Newark, NJ 07114. The listed phone number is (615) 468-3188.

What is Premise Health Of New Jersey Medical, P.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Premise Health Of New Jersey Medical, P.C. hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Premise Health Of New Jersey Medical, P.C. was last updated on November 15, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.