31D2143083 CLIA NUMBER - HENRY J AUSTIN HEALTH CENTER

Laboratory Demographics

CLIA Number: 31D2143083

Facility Name: HENRY J AUSTIN HEALTH CENTER

Facility Address:
112 EWING ST
TRENTON, NJ
ZIP 08609
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Facility Phone Number: 609 278-5900

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1477980845

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D2143083
LAB Type	Federally Qualified Health Center
Facility Name	HENRY J AUSTIN HEALTH CENTER
Street	112 EWING ST
City	TRENTON
State	NJ
ZIP	08609
Phone	609 278-5900
CertificateType	4
CertificateEffectiveDate	1/24/2024
CertificateExpirationDate	1/23/2026
FacilityType	Waiver

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