31D1098366 CLIA NUMBER - LOURDES INNOVA DIALYSIS

Laboratory Demographics

  • CLIA Code: 31D1098366
  • Facility Name: LOURDES INNOVA DIALYSIS
  • Facility Address: 3716 CHURCH ROAD
    MOUNT LAUREL, NJ
    ZIP 08054
  • Facility Phone: 856 222-0386
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RICHARD L. SPECTER
  • NPI Number: 1215287941
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D1098366
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LOURDES INNOVA DIALYSIS
Street 3716 CHURCH ROAD
City MOUNT LAUREL
State NJ
ZIP 08054
Phone 856 222-0386
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/17/2025
Certificate Expiration Date 4/16/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RICHARD L. SPECTER

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