39D0192639 CLIA NUMBER - GLENN BROOK REHAB & HLTHCARE CTR LLC

Laboratory Demographics

  • CLIA Code: 39D0192639
  • Facility Name: GLENN BROOK REHAB & HLTHCARE CTR LLC
  • Facility Address: 801 EAST 16TH
    BERWICK, PA
    ZIP 18603
  • Facility Phone: 570 759-5400
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. GARY D. KANOUSE
  • NPI Number: 1770130825
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D0192639
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GLENN BROOK REHAB & HLTHCARE CTR LLC
Street 801 EAST 16TH
City BERWICK
State PA
ZIP 18603
Phone 570 759-5400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. GARY D. KANOUSE

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