31D1025752 CLIA NUMBER - MT LAUREL ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 31D1025752
  • Facility Name: MT LAUREL ENDOSCOPY CENTER
  • Facility Address: 15000 MIDLANTIC DRIVE SUITE 110
    MOUNT LAUREL, NJ
    ZIP 08054
  • Facility Phone: 609 654-0230
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SCOTT J. MODENA
  • NPI Number: 1144275900
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 31D1025752
LAB Type Physician Office
Facility Name MT LAUREL ENDOSCOPY CENTER
Street 15000 MIDLANTIC DRIVE SUITE 110
City MOUNT LAUREL
State NJ
ZIP 08054
Phone 609 654-0230
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2024
Certificate Expiration Date 5/16/2026
Facility Type Physician Office
Lab Director SCOTT J. MODENA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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