31D1036059 CLIA NUMBER - VANTAGE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 31D1036059
  • Facility Name: VANTAGE SURGERY CENTER
  • Facility Address: 350 YOUNG AVENUE
    MOORESTOWN, NJ
    ZIP 08057
  • Facility Phone: 609 654-5795
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JOHN M. GRAY
  • NPI Number: 1528016656
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D1036059
LAB Type Ambulatory Surgery Center
Facility Name VANTAGE SURGERY CENTER
Street 350 YOUNG AVENUE
City MOORESTOWN
State NJ
ZIP 08057
Phone 609 654-5795
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2025
Certificate Expiration Date 3/5/2027
Facility Type Ambulatory Surgery Center
Lab Director JOHN M. GRAY

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