39D2115703 CLIA NUMBER - PREMIER AT EXTON SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 39D2115703
  • Facility Name: PREMIER AT EXTON SURGERY CENTER LLC
  • Facility Address: 491 JOHN YOUNG WAY SUITE 100
    EXTON, PA
    ZIP 19341
  • Facility Phone: 610 960-0149
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. DAVID C. RAAB
  • NPI Number: 1376906354
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2115703
LAB Type Ambulatory Surgery Center
Facility Name PREMIER AT EXTON SURGERY CENTER LLC
Street 491 JOHN YOUNG WAY SUITE 100
City EXTON
State PA
ZIP 19341
Phone 610 960-0149
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/12/2024
Certificate Expiration Date 7/11/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. DAVID C. RAAB

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