31D2237776 CLIA NUMBER - BROADSTEP ACADEMY

Laboratory Demographics

CLIA Code: 31D2237776
Facility Name: BROADSTEP ACADEMY
Facility Address: 8 WILSON DRIVE
SPARTA, NJ
ZIP 07871
Facility Phone: 973 579-3700
Facility Type: Intermediate Care Facility for Mentally Retarded
Facility Type: Waiver
Lab Director: ELIMI DE LA ROSA
NPI Number: 1821473471
Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	31D2237776
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	BROADSTEP ACADEMY
Street	8 WILSON DRIVE
City	SPARTA
State	NJ
ZIP	07871
Phone	973 579-3700
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	9/28/2025
Certificate Expiration Date	9/27/2027
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	ELIMI DE LA ROSA

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