39D2313227 CLIA NUMBER - SPARK WELLNESS LLC

Laboratory Demographics

  • CLIA Code: 39D2313227
  • Facility Name: SPARK WELLNESS LLC
  • Facility Address: 301 OXFORD VALLEY RD, SUITE 1302A
    YARDLEY, PA
    ZIP 19067
  • Facility Phone: 267 399-3990
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: DR. JASON LULEJIAN
  • NPI Number: 1720769607
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D2313227
LAB Type Comp. Outpatient Rehab Facility
Facility Name SPARK WELLNESS LLC
Street 301 OXFORD VALLEY RD, SUITE 1302A
City YARDLEY
State PA
ZIP 19067
Phone 267 399-3990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director DR. JASON LULEJIAN

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