31D2235590 CLIA NUMBER - SPECIAL NEEDS RESIDENCE LLC DBA MT BETHEL VILLAGE

Laboratory Demographics

CLIA Code: 31D2235590
Facility Name: SPECIAL NEEDS RESIDENCE LLC DBA MT BETHEL VILLAGE
Facility Address: 130 MT BETHEL ROAD
WARREN, NJ
ZIP 07059
Facility Phone: 908 757-7000
Facility Type: Intermediate Care Facility for Mentally Retarded
Facility Type: Waiver
Lab Director: RONALD G. NAHASS
NPI Number: 1811553217
Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	31D2235590
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	SPECIAL NEEDS RESIDENCE LLC DBA MT BETHEL VILLAGE
Street	130 MT BETHEL ROAD
City	WARREN
State	NJ
ZIP	07059
Phone	908 757-7000
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	9/10/2025
Certificate Expiration Date	9/9/2027
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	RONALD G. NAHASS

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