31D0962900 CLIA NUMBER - PROSPECT HEIGHTS CARE CENTER

Laboratory Demographics

CLIA Number: 31D0962900

Facility Name: PROSPECT HEIGHTS CARE CENTER

Facility Address:
336 PROSPECT AVENUE
HACKENSACK, NJ
ZIP 07601
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Facility Phone Number: 201 678-1801

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1023162385

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D0962900
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	PROSPECT HEIGHTS CARE CENTER
Street	336 PROSPECT AVENUE
City	HACKENSACK
State	NJ
ZIP	07601
Phone	201 678-1801
CertificateType	4
CertificateEffectiveDate	7/16/2023
CertificateExpirationDate	7/15/2025
FacilityType	Waiver

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