31D2206109 CLIA NUMBER - BRANDYWINE

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Laboratory Demographics

CLIA Number: 31D2206109

Facility Name: BRANDYWINE

Facility Address:
143 WEST FRANKLIN AVENUE
PENNINGTON, NJ
ZIP 08534
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Facility Phone Number: 609 730-9922

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1396026456

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	31D2206109
LAB Type	Assisted Living Facility
Facility Name	BRANDYWINE
Street	143 WEST FRANKLIN AVENUE
City	PENNINGTON
State	NJ
ZIP	08534
Phone	609 730-9922
CertificateType	4
CertificateEffectiveDate	12/17/2022
CertificateExpirationDate	12/16/2024
FacilityType	Waiver

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