31D1068009 CLIA NUMBER - FELLOWSHIP SURGICAL CENTER

Laboratory Demographics

CLIA Number: 31D1068009

Facility Name: FELLOWSHIP SURGICAL CENTER

Facility Address:
715 FELLOWSHIP ROAD SUITE A
MOUNT LAUREL, NJ
ZIP 08054
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Facility Phone Number: 856 316-4600

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1952623936

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D1068009
LAB Type	Ambulatory Surgery Center
Facility Name	FELLOWSHIP SURGICAL CENTER
Street	715 FELLOWSHIP ROAD SUITE A
City	MOUNT LAUREL
State	NJ
ZIP	08054
Phone	856 316-4600
CertificateType	4
CertificateEffectiveDate	5/1/2023
CertificateExpirationDate	4/30/2025
FacilityType	Waiver

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