39D0189070 CLIA NUMBER - BUCKTAIL MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 39D0189070
  • Facility Name: BUCKTAIL MEDICAL CENTER
  • Facility Address: 1001 PINE STREET
    SOUTH RENOVO, PA
    ZIP 17764
  • Facility Phone: 570 447-9566
  • Facility Type: Hospital
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. HUSAM F. HAMATI
  • NPI Number: 1821083700
  • Taxonomy: 282NC0060X - General Acute Care Hospital

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 39D0189070
LAB Type Hospital
Facility Name BUCKTAIL MEDICAL CENTER
Street 1001 PINE STREET
City SOUTH RENOVO
State PA
ZIP 17764
Phone 570 447-9566
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 11/16/2023
Certificate Expiration Date 11/15/2025
Facility Type Hospital
Lab Director DR. HUSAM F. HAMATI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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