39D2022379 CLIA NUMBER - CHILDRENS DENTAL SURGERY

Laboratory Demographics

  • CLIA Code: 39D2022379
  • Facility Name: CHILDRENS DENTAL SURGERY
  • Facility Address: 2160 NOLL DRIVE SUITE 300
    LANCASTER, PA
    ZIP 17603
  • Facility Phone: 717 481-4828
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. ANTHONY J. MONTEIRO
  • NPI Number: 1619284536
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2022379
LAB Type Ambulatory Surgery Center
Facility Name CHILDRENS DENTAL SURGERY
Street 2160 NOLL DRIVE SUITE 300
City LANCASTER
State PA
ZIP 17603
Phone 717 481-4828
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. ANTHONY J. MONTEIRO

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