39D0185337 CLIA NUMBER - NORTHERN POTTER HEALTH CENTER CHARLES COLE MEMORIAL HOSPITAL

Laboratory Demographics

  • CLIA Code: 39D0185337
  • Facility Name: NORTHERN POTTER HEALTH CENTER CHARLES COLE MEMORIAL HOSPITAL
  • Facility Address: 511 ACADEMY STREET
    ULYSSES, PA
    ZIP 16948
  • Facility Phone: 814 848-7555
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JEFFREY S. NOLT
  • NPI Number: 1144997016
  • Taxonomy: 235Z00000X - Speech-Language Pathologist

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CLIA Record

Field Name Field Value
CLIA Number 39D0185337
LAB Type Physician Office
Facility Name NORTHERN POTTER HEALTH CENTER CHARLES COLE MEMORIAL HOSPITAL
Street 511 ACADEMY STREET
City ULYSSES
State PA
ZIP 16948
Phone 814 848-7555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2024
Certificate Expiration Date 3/23/2026
Facility Type Physician Office
Lab Director DR. JEFFREY S. NOLT

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