31D2191294 CLIA NUMBER - EDEN AUTISM SERVICES

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Laboratory Demographics

CLIA Number: 31D2191294

Facility Name: EDEN AUTISM SERVICES

Facility Address:
2 MERWICK ROAD
PRINCETON, NJ
ZIP 08540
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Facility Phone Number: 609 987-0099

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1427433713

Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

CLIA Record

Field Name	Field Value
CLIA Number	31D2191294
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	EDEN AUTISM SERVICES
Street	2 MERWICK ROAD
City	PRINCETON
State	NJ
ZIP	08540
Phone	609 987-0099
CertificateType	4
CertificateEffectiveDate	8/25/2022
CertificateExpirationDate	8/24/2024
FacilityType	Waiver

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