31D2195419 CLIA NUMBER - BROOKDALE EMERSON

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Laboratory Demographics

CLIA Number: 31D2195419

Facility Name: BROOKDALE EMERSON

Facility Address:
590 OLD HOOK ROAD
EMERSON, NJ
ZIP 07630
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Facility Phone Number: 201 986-9009

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1215146832

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	31D2195419
LAB Type	Assisted Living Facility
Facility Name	BROOKDALE EMERSON
Street	590 OLD HOOK ROAD
City	EMERSON
State	NJ
ZIP	07630
Phone	201 986-9009
CertificateType	4
CertificateEffectiveDate	10/8/2022
CertificateExpirationDate	10/7/2024
FacilityType	Waiver

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