31D2168409 CLIA NUMBER - ACTIVE DAY AT CASA MANITO

Laboratory Demographics

  • CLIA Code: 31D2168409
  • Facility Name: ACTIVE DAY AT CASA MANITO
  • Facility Address: 324 55TH ST
    WEST NEW YORK, NJ
    ZIP 07093
  • Facility Phone: 215 642-6269
  • Facility Type: Other - ADULT DAY CARE
  • Facility Type: Waiver
  • Lab Director: HAERNMERLE JENNIE
  • NPI Number: 1760915821
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2168409
LAB Type Other - ADULT DAY CARE
Facility Name ACTIVE DAY AT CASA MANITO
Street 324 55TH ST
City WEST NEW YORK
State NJ
ZIP 07093
Phone 215 642-6269
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2023
Certificate Expiration Date 6/27/2025
Facility Type Other - ADULT DAY CARE
Lab Director HAERNMERLE JENNIE

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This page was last updated on: 6/4/2025