39D2042857 CLIA NUMBER - GEISINGER GRAYS WOODS OP SURGERY

Laboratory Demographics

  • CLIA Code: 39D2042857
  • Facility Name: GEISINGER GRAYS WOODS OP SURGERY
  • Facility Address: 132 ABIGAIL LANE
    PORT MATILDA, PA
    ZIP 16870
  • Facility Phone: 814 272-5011
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL T. HEGSTROM
  • NPI Number: 1083874770
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D2042857
LAB Type Ambulatory Surgery Center
Facility Name GEISINGER GRAYS WOODS OP SURGERY
Street 132 ABIGAIL LANE
City PORT MATILDA
State PA
ZIP 16870
Phone 814 272-5011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2024
Certificate Expiration Date 6/20/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. MICHAEL T. HEGSTROM

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