31D2311288 CLIA NUMBER - ELWYN NEW JERSEY

Laboratory Demographics

CLIA Code: 31D2311288
Facility Name: ELWYN NEW JERSEY
Facility Address: 228 W LANDIS AVENUE BUILDING C
VINELAND, NJ
ZIP 08360
Facility Phone: 856 794-5279
Facility Type: Other - GRP HOME SETTING/DAY PROG
Facility Type: Waiver
Lab Director: LATIA PIERCE
NPI Number: 1164958302
Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	31D2311288
LAB Type	Other - GRP HOME SETTING/DAY PROG
Facility Name	ELWYN NEW JERSEY
Street	228 W LANDIS AVENUE BUILDING C
City	VINELAND
State	NJ
ZIP	08360
Phone	856 794-5279
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	9/19/2024
Certificate Expiration Date	9/18/2026
Facility Type	Other - GRP HOME SETTING/DAY PROG
Lab Director	LATIA PIERCE

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