39D0955073 CLIA NUMBER - DCA OF CHAMBERSBURG, INC

Laboratory Demographics

CLIA Number: 39D0955073

Facility Name: DCA OF CHAMBERSBURG, INC

Facility Address:
PARK 5TH AVE PROF CTR, STE A, 765 5TH AVE
CHAMBERSBURG, PA
ZIP 17201
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Facility Phone Number: 717 263-9300

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1033172556

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D0955073
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DCA OF CHAMBERSBURG, INC
Street	PARK 5TH AVE PROF CTR, STE A, 765 5TH AVE
City	CHAMBERSBURG
State	PA
ZIP	17201
Phone	717 263-9300
CertificateType	4
CertificateEffectiveDate	12/17/2022
CertificateExpirationDate	12/16/2024
FacilityType	Waiver

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