39D1057617 CLIA NUMBER - MOUNTAIN LAUREL SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 39D1057617
  • Facility Name: MOUNTAIN LAUREL SURGERY CENTER
  • Facility Address: 1860 FAIR AVENUE SUITE B
    HONESDALE, PA
    ZIP 18431
  • Facility Phone: 570 253-3391
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DAVID D. REYNOLDS MD
  • NPI Number: 1518916758
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D1057617
LAB Type Ambulatory Surgery Center
Facility Name MOUNTAIN LAUREL SURGERY CENTER
Street 1860 FAIR AVENUE SUITE B
City HONESDALE
State PA
ZIP 18431
Phone 570 253-3391
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2024
Certificate Expiration Date 8/16/2026
Facility Type Ambulatory Surgery Center
Lab Director DAVID D. REYNOLDS MD

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