31D2123539 CLIA NUMBER - KEYSTONE RECOVERY CENTER, INC

Laboratory Demographics

  • CLIA Code: 31D2123539
  • Facility Name: KEYSTONE RECOVERY CENTER, INC
  • Facility Address: 482 NOTCH ROAD
    WOODLAND PARK, NJ
    ZIP 07424
  • Facility Phone: 973 298-5776
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: JOSEPH GOVERNARA
  • NPI Number: 1275980161
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 31D2123539
LAB Type Comp. Outpatient Rehab Facility
Facility Name KEYSTONE RECOVERY CENTER, INC
Street 482 NOTCH ROAD
City WOODLAND PARK
State NJ
ZIP 07424
Phone 973 298-5776
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2024
Certificate Expiration Date 12/21/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director JOSEPH GOVERNARA

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This page was last updated on: 3/20/2025