39D1047644 CLIA NUMBER - CROZER KEYSTONE SURGERY CENTER AT BRINTON LAKE

Laboratory Demographics

  • CLIA Code: 39D1047644
  • Facility Name: CROZER KEYSTONE SURGERY CENTER AT BRINTON LAKE
  • Facility Address: 300 EVERGREEN DRIVE SUITE 320
    GLEN MILLS, PA
    ZIP 19342
  • Facility Phone: 484 846-5100
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. ADAM HAUSER
  • NPI Number: 1083061006
  • Taxonomy: 208100000X - Physical Medicine & Rehabilitation

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CLIA Record

Field Name Field Value
CLIA Number 39D1047644
LAB Type Ambulatory Surgery Center
Facility Name CROZER KEYSTONE SURGERY CENTER AT BRINTON LAKE
Street 300 EVERGREEN DRIVE SUITE 320
City GLEN MILLS
State PA
ZIP 19342
Phone 484 846-5100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2023
Certificate Expiration Date 11/8/2025
Facility Type Ambulatory Surgery Center
Lab Director DR. ADAM HAUSER

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This page was last updated on: 3/20/2025