31D2173931 CLIA NUMBER - MORDECAI & CARAVELLO WELLNESS LLC DBA MEDI WEIGHTLOSS

Laboratory Demographics

  • CLIA Code: 31D2173931
  • Facility Name: MORDECAI & CARAVELLO WELLNESS LLC DBA MEDI WEIGHTLOSS
  • Facility Address: 1401 MARLTON PIKE EAST, SUITE 14
    CHERRY HILL, NJ
    ZIP 08034
  • Facility Phone: 908 420-1037
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: RUSSELL E. MORDECAI
  • NPI Number: 1407409360
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2173931
LAB Type Practitioner Other
Facility Name MORDECAI & CARAVELLO WELLNESS LLC DBA MEDI WEIGHTLOSS
Street 1401 MARLTON PIKE EAST, SUITE 14
City CHERRY HILL
State NJ
ZIP 08034
Phone 908 420-1037
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2025
Certificate Expiration Date 10/21/2027
Facility Type Practitioner Other
Lab Director RUSSELL E. MORDECAI

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