31D2159740 CLIA NUMBER - MARYVILLE INC

Laboratory Demographics

  • CLIA Code: 31D2159740
  • Facility Name: MARYVILLE INC
  • Facility Address: 1903 GRANT AVE
    WILLIAMSTOWN, NJ
    ZIP 08094
  • Facility Phone: 856 629-0244
  • Facility Type: Other - ADDICTION TREATMENT CENTE
  • Facility Type: Waiver
  • Lab Director: KENDRIA MCWILLIAMS
  • NPI Number: 1073023354
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 31D2159740
LAB Type Other - ADDICTION TREATMENT CENTE
Facility Name MARYVILLE INC
Street 1903 GRANT AVE
City WILLIAMSTOWN
State NJ
ZIP 08094
Phone 856 629-0244
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/26/2024
Certificate Expiration Date 12/25/2026
Facility Type Other - ADDICTION TREATMENT CENTE
Lab Director KENDRIA MCWILLIAMS

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