39D2019757 CLIA NUMBER - PENN STATE HERSHEY ENDOSCOPY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 39D2019757
  • Facility Name: PENN STATE HERSHEY ENDOSCOPY CENTER, LLC
  • Facility Address: 32 COLONNADE WAY
    STATE COLLEGE, PA
    ZIP 16803
  • Facility Phone: 814 272-4481
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. BRIAN D. DODSON
  • NPI Number: 1073816690
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2019757
LAB Type Ambulatory Surgery Center
Facility Name PENN STATE HERSHEY ENDOSCOPY CENTER, LLC
Street 32 COLONNADE WAY
City STATE COLLEGE
State PA
ZIP 16803
Phone 814 272-4481
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. BRIAN D. DODSON

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This page was last updated on: 6/4/2025