31D2194608 CLIA NUMBER - MIRA VIE AT BRICK

Laboratory Demographics

  • CLIA Code: 31D2194608
  • Facility Name: MIRA VIE AT BRICK
  • Facility Address: 458 JACK MARTIN BLVD
    BRICK, NJ
    ZIP 08724
  • Facility Phone: 732 206-9800
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TERRY K. BROOKS
  • NPI Number: 1992085377
  • Taxonomy: 310400000X - Assisted Living Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 31D2194608
LAB Type Assisted Living Facility
Facility Name MIRA VIE AT BRICK
Street 458 JACK MARTIN BLVD
City BRICK
State NJ
ZIP 08724
Phone 732 206-9800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2024
Certificate Expiration Date 9/30/2026
Facility Type Assisted Living Facility
Lab Director TERRY K. BROOKS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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