31D2208384 CLIA NUMBER - IVYSTONE SENIOR LIVING

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Laboratory Demographics

CLIA Number: 31D2208384

Facility Name: IVYSTONE SENIOR LIVING

Facility Address:
7999 ROUTE 130
PENNSAUKEN, NJ
ZIP 08110
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Facility Phone Number: 856 488-5557

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1306969829

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	31D2208384
LAB Type	Assisted Living Facility
Facility Name	IVYSTONE SENIOR LIVING
Street	7999 ROUTE 130
City	PENNSAUKEN
State	NJ
ZIP	08110
Phone	856 488-5557
CertificateType	4
CertificateEffectiveDate	1/6/2023
CertificateExpirationDate	1/5/2025
FacilityType	Waiver

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