39D1075904 CLIA NUMBER - STATE HILL SURGICENTER LLC

Laboratory Demographics

  • CLIA Code: 39D1075904
  • Facility Name: STATE HILL SURGICENTER LLC
  • Facility Address: 2630 WESTVIEW DRIVE
    WYOMISSING, PA
    ZIP 19610
  • Facility Phone: 610 376-1981
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MOIZ M. CARIM MD
  • NPI Number: 1225050347
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D1075904
LAB Type Ambulatory Surgery Center
Facility Name STATE HILL SURGICENTER LLC
Street 2630 WESTVIEW DRIVE
City WYOMISSING
State PA
ZIP 19610
Phone 610 376-1981
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type Ambulatory Surgery Center
Lab Director MOIZ M. CARIM MD

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