31D0664952 CLIA NUMBER - SURGICAL CENTER OF SOUTH JERSEY LTD PARTNERSHIP DBA SURGICAL CENTER OF SOUTH JERSEY

Laboratory Demographics

CLIA Number: 31D0664952

Facility Name: SURGICAL CENTER OF SOUTH JERSEY LTD PARTNERSHIP DBA SURGICAL CENTER OF SOUTH JERSEY

Facility Address:
130 GAITHER DRIVE SUITE 160
MOUNT LAUREL, NJ
ZIP 08054
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Facility Phone Number: 609 722-7000

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1689639692

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D0664952
LAB Type	Ambulatory Surgery Center
Facility Name	SURGICAL CENTER OF SOUTH JERSEY LTD PARTNERSHIP DBA SURGICAL CENTER OF SOUTH JERSEY
Street	130 GAITHER DRIVE SUITE 160
City	MOUNT LAUREL
State	NJ
ZIP	08054
Phone	609 722-7000
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024