39D0904034 CLIA NUMBER - MANOR AT SUSQUEHANNA VILLAGE, THE

Laboratory Demographics

  • CLIA Code: 39D0904034
  • Facility Name: MANOR AT SUSQUEHANNA VILLAGE, THE
  • Facility Address: 990 MEDICAL ROAD
    MILLERSBURG, PA
    ZIP 17061
  • Facility Phone: (717) 692-4751
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ROBERT A. ETTLINGER MD
  • NPI Number: 1669496287
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D0904034
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MANOR AT SUSQUEHANNA VILLAGE, THE
Street 990 MEDICAL ROAD
City MILLERSBURG
State PA
ZIP 17061
Phone 7176924751
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2025
Certificate Expiration Date 8/3/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ROBERT A. ETTLINGER MD

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This page was last updated on: 5/18/2026