39D0193087 CLIA NUMBER - EDENBROOK AT HAMPTON

Laboratory Demographics

  • CLIA Code: 39D0193087
  • Facility Name: EDENBROOK AT HAMPTON
  • Facility Address: 1548 SANS SOUCI PKWY
    WILKES BARRE, PA
    ZIP 18702
  • Facility Phone: 570 825-8725
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. BASANT K. MITTAL
  • NPI Number: 1417533076
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D0193087
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EDENBROOK AT HAMPTON
Street 1548 SANS SOUCI PKWY
City WILKES BARRE
State PA
ZIP 18702
Phone 570 825-8725
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. BASANT K. MITTAL

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