31D0965764 CLIA NUMBER - CENTENNIAL SURGICAL CENTER

Laboratory Demographics

CLIA Number: 31D0965764

Facility Name: CENTENNIAL SURGICAL CENTER

Facility Address:
502 CENTENNIAL BLVD SUITE 1
VOORHEES, NJ
ZIP 08043
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Facility Phone Number: 856 874-0790

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1225293087

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D0965764
LAB Type	Ambulatory Surgery Center
Facility Name	CENTENNIAL SURGICAL CENTER
Street	502 CENTENNIAL BLVD SUITE 1
City	VOORHEES
State	NJ
ZIP	08043
Phone	856 874-0790
CertificateType	4
CertificateEffectiveDate	9/28/2023
CertificateExpirationDate	9/27/2025
FacilityType	Waiver

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