31D0683245 CLIA NUMBER - CHILDREN'S SPECIALIZED HOSPITAL MOUNTAINSIDE LTC

Laboratory Demographics

  • CLIA Code: 31D0683245
  • Facility Name: CHILDREN'S SPECIALIZED HOSPITAL MOUNTAINSIDE LTC
  • Facility Address: 150 NEW PROVIDENCE RD
    MOUNTAINSIDE, NJ
    ZIP 07092
  • Facility Phone: 732 789-7668
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Certificate of Compliance
  • Lab Director: MARY CARAYANNOPOULOS
  • NPI Number: 1639210180
  • Taxonomy: 332BC3200X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 31D0683245
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CHILDREN'S SPECIALIZED HOSPITAL MOUNTAINSIDE LTC
Street 150 NEW PROVIDENCE RD
City MOUNTAINSIDE
State NJ
ZIP 07092
Phone 732 789-7668
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 9/20/2025
Certificate Expiration Date 9/19/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MARY CARAYANNOPOULOS

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This page was last updated on: 9/29/2025