39D0898158 CLIA NUMBER - OPHTHALMOLOGY SURGICAL CENTER INC

Laboratory Demographics

CLIA Number: 39D0898158

Facility Name: OPHTHALMOLOGY SURGICAL CENTER INC

Facility Address:
92 TUSCARORA STREET, 2ND FLR
HARRISBURG, PA
ZIP 17104
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Facility Phone Number: 717 233-2020

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1174525521

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D0898158
LAB Type	Ambulatory Surgery Center
Facility Name	OPHTHALMOLOGY SURGICAL CENTER INC
Street	92 TUSCARORA STREET, 2ND FLR
City	HARRISBURG
State	PA
ZIP	17104
Phone	717 233-2020
CertificateType	4
CertificateEffectiveDate	2/23/2023
CertificateExpirationDate	2/22/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024