31D2099065 CLIA NUMBER - LEAP HEALTH & WELLNESS CENTER

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Laboratory Demographics

CLIA Number: 31D2099065

Facility Name: LEAP HEALTH & WELLNESS CENTER

Facility Address:
130 NORTH BROADWAY, 10TH FLOOR STEAM HIGH SCHOOL CAMPUS
CAMDEN, NJ
ZIP 08102
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Facility Phone Number: 856 614-5610

Facility Type: Other - SCHOOL BASED HLT CTR

Certificate Type: Waiver

NPI Number: 1912325077

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D2099065
LAB Type	Other - SCHOOL BASED HLT CTR
Facility Name	LEAP HEALTH & WELLNESS CENTER
Street	130 NORTH BROADWAY, 10TH FLOOR STEAM HIGH SCHOOL CAMPUS
City	CAMDEN
State	NJ
ZIP	08102
Phone	856 614-5610
CertificateType	4
CertificateEffectiveDate	7/20/2023
CertificateExpirationDate	7/19/2025
FacilityType	Waiver

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