31D1071386 CLIA NUMBER - EMMAUS SURGICAL CENTER LLC

Laboratory Demographics

CLIA Number: 31D1071386

Facility Name: EMMAUS SURGICAL CENTER LLC

Facility Address:
57 ROUTE 46 SUITE 104
HACKETTSTOWN, NJ
ZIP 07840
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Facility Phone Number: 201 851-0802

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1215134564

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D1071386
LAB Type	Ambulatory Surgery Center
Facility Name	EMMAUS SURGICAL CENTER LLC
Street	57 ROUTE 46 SUITE 104
City	HACKETTSTOWN
State	NJ
ZIP	07840
Phone	201 851-0802
CertificateType	4
CertificateEffectiveDate	7/25/2023
CertificateExpirationDate	7/24/2025
FacilityType	Waiver

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