31D2090807 CLIA NUMBER - COASTAL SPINE

Laboratory Demographics

  • CLIA Code: 31D2090807
  • Facility Name: COASTAL SPINE
  • Facility Address: 4000 CHURCH ROAD
    MOUNT LAUREL, NJ
    ZIP 08054
  • Facility Phone: 856 222-4444
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SCOTT JARMAIN
  • NPI Number: 1417985094
  • Taxonomy: 207XS0117X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 31D2090807
LAB Type Physician Office
Facility Name COASTAL SPINE
Street 4000 CHURCH ROAD
City MOUNT LAUREL
State NJ
ZIP 08054
Phone 856 222-4444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2025
Certificate Expiration Date 1/29/2027
Facility Type Physician Office
Lab Director SCOTT JARMAIN

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