21D1012034 CLIA NUMBER - CUMBERLAND VALLEY SURGERY CENTER

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Laboratory Demographics

CLIA Number: 21D1012034

Facility Name: CUMBERLAND VALLEY SURGERY CENTER

Facility Address:
1110 PROFESSIONAL COURT
HAGERSTOWN, MD
ZIP 21740
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Facility Phone Number: 123 123-1236

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1730670456

Taxonomy: 163WL0100X - Registered Nurse

CLIA Record

Field Name	Field Value
CLIA Number	21D1012034
LAB Type	Ambulatory Surgery Center
Facility Name	CUMBERLAND VALLEY SURGERY CENTER
Street	1110 PROFESSIONAL COURT
City	HAGERSTOWN
State	MD
ZIP	21740
Phone	123 123-1236
CertificateType	4
CertificateEffectiveDate	4/30/2023
CertificateExpirationDate	4/29/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024