31D2251458 CLIA NUMBER - RENEWED LIGHT, LLC

Laboratory Demographics

  • CLIA Code: 31D2251458
  • Facility Name: RENEWED LIGHT, LLC
  • Facility Address: 1225 BROAD STREET UNIT 1
    WEST DEPTFORD, NJ
    ZIP 08096
  • Facility Phone: 856 508-0966
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: JESSICA MERCIER
  • NPI Number: 1104578889
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2251458
LAB Type Comp. Outpatient Rehab Facility
Facility Name RENEWED LIGHT, LLC
Street 1225 BROAD STREET UNIT 1
City WEST DEPTFORD
State NJ
ZIP 08096
Phone 856 508-0966
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2024
Certificate Expiration Date 2/2/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director JESSICA MERCIER

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