39D0189138 CLIA NUMBER - GEISINGER BENTON

Laboratory Demographics

  • CLIA Code: 39D0189138
  • Facility Name: GEISINGER BENTON
  • Facility Address: 4469 RED ROCK ROAD
    BENTON, PA
    ZIP 17814
  • Facility Phone: 570 925-6424
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RICHARD A. PRISUTA MD
  • NPI Number: 1306193826
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0189138
LAB Type Physician Office
Facility Name GEISINGER BENTON
Street 4469 RED ROCK ROAD
City BENTON
State PA
ZIP 17814
Phone 570 925-6424
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/20/2025
Certificate Expiration Date 6/19/2027
Facility Type Physician Office
Lab Director DR. RICHARD A. PRISUTA MD

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