31D2155353 CLIA NUMBER - VIRTUA - PEDIATRIC MOBILE SERVICES

Laboratory Demographics

  • CLIA Code: 31D2155353
  • Facility Name: VIRTUA - PEDIATRIC MOBILE SERVICES
  • Facility Address: 523 FELLOWSHIP ROAD, SUITE 270
    MOUNT LAUREL, NJ
    ZIP 08054
  • Facility Phone: 856 581-7381
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: MARY CAMPAGNOLO
  • NPI Number: 1184811945
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 31D2155353
LAB Type Mobile Laboratory
Facility Name VIRTUA - PEDIATRIC MOBILE SERVICES
Street 523 FELLOWSHIP ROAD, SUITE 270
City MOUNT LAUREL
State NJ
ZIP 08054
Phone 856 581-7381
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Mobile Laboratory
Lab Director MARY CAMPAGNOLO

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