39D1010108 CLIA NUMBER - PA EYE & EAR SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 39D1010108
  • Facility Name: PA EYE & EAR SURGERY CENTER LLC
  • Facility Address: 1 GRANITE POINT DRIVE SUITE 200
    WYOMISSING, PA
    ZIP 19610
  • Facility Phone: 610 685-9204
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JONATHAN D. PRIMACK
  • NPI Number: 1609848472
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D1010108
LAB Type Ambulatory Surgery Center
Facility Name PA EYE & EAR SURGERY CENTER LLC
Street 1 GRANITE POINT DRIVE SUITE 200
City WYOMISSING
State PA
ZIP 19610
Phone 610 685-9204
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2025
Certificate Expiration Date 3/5/2027
Facility Type Ambulatory Surgery Center
Lab Director JONATHAN D. PRIMACK

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