31D2234440 CLIA NUMBER - NEURORESTORATIVE LARCHMONT

Laboratory Demographics

  • CLIA Code: 31D2234440
  • Facility Name: NEURORESTORATIVE LARCHMONT
  • Facility Address: 1501 LARCHMONT PL
    MOUNT LAUREL, NJ
    ZIP 08054
  • Facility Phone: 609 731-2938
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: DEBBORA BERGMAN
  • NPI Number: 1679082234
  • Taxonomy: 283X00000X - Rehabilitation Hospital

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CLIA Record

Field Name Field Value
CLIA Number 31D2234440
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name NEURORESTORATIVE LARCHMONT
Street 1501 LARCHMONT PL
City MOUNT LAUREL
State NJ
ZIP 08054
Phone 609 731-2938
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2025
Certificate Expiration Date 8/30/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director DEBBORA BERGMAN

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