39D1079586 CLIA NUMBER - GEISINGER WILKES BARRE HANOVER

Laboratory Demographics

  • CLIA Code: 39D1079586
  • Facility Name: GEISINGER WILKES BARRE HANOVER
  • Facility Address: 166 HANOVER STREET, SUITE 200
    WILKES BARRE, PA
    ZIP 18702
  • Facility Phone: 570 825-8780
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JASON R. WOLOSKI
  • NPI Number: 1043408826
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D1079586
LAB Type Physician Office
Facility Name GEISINGER WILKES BARRE HANOVER
Street 166 HANOVER STREET, SUITE 200
City WILKES BARRE
State PA
ZIP 18702
Phone 570 825-8780
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2025
Certificate Expiration Date 2/28/2027
Facility Type Physician Office
Lab Director DR. JASON R. WOLOSKI

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