31D2007444 CLIA NUMBER - LOURDES MT LAUREL DIALYSIS

Laboratory Demographics

  • CLIA Code: 31D2007444
  • Facility Name: LOURDES MT LAUREL DIALYSIS
  • Facility Address: 130 GAITHER DRIVE, SUITE 172
    MOUNT LAUREL, NJ
    ZIP 08054
  • Facility Phone: 856 222-4195
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: BRETT S. ROSENTHAL
  • NPI Number: 1760732408
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2007444
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LOURDES MT LAUREL DIALYSIS
Street 130 GAITHER DRIVE, SUITE 172
City MOUNT LAUREL
State NJ
ZIP 08054
Phone 856 222-4195
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2024
Certificate Expiration Date 5/17/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director BRETT S. ROSENTHAL

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