31D2273705 CLIA NUMBER - GARDEN STATE TREATMENT CENTER BH LLC

Laboratory Demographics

  • CLIA Code: 31D2273705
  • Facility Name: GARDEN STATE TREATMENT CENTER BH LLC
  • Facility Address: 350 SPARTA AVE STE A-201
    SPARTA, NJ
    ZIP 07871
  • Facility Phone: 954 425-2949
  • Facility Type: Other - SUBSTANCE USE TREATMENT F
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL GANON
  • NPI Number: 1548751258
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 31D2273705
LAB Type Other - SUBSTANCE USE TREATMENT F
Facility Name GARDEN STATE TREATMENT CENTER BH LLC
Street 350 SPARTA AVE STE A-201
City SPARTA
State NJ
ZIP 07871
Phone 954 425-2949
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Other - SUBSTANCE USE TREATMENT F
Lab Director DR. MICHAEL GANON

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