39D2131547 CLIA NUMBER - WAKEFIELD AMBULANCE ASSOCIATION

Laboratory Demographics

  • CLIA Code: 39D2131547
  • Facility Name: WAKEFIELD AMBULANCE ASSOCIATION
  • Facility Address: 2272 ROBERT FULTON HWY
    PEACH BOTTOM, PA
    ZIP 17563
  • Facility Phone: 717 955-0152
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: PHILIP D. MAHAN
  • NPI Number: 1588600977
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 39D2131547
LAB Type Ambulance
Facility Name WAKEFIELD AMBULANCE ASSOCIATION
Street 2272 ROBERT FULTON HWY
City PEACH BOTTOM
State PA
ZIP 17563
Phone 717 955-0152
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Ambulance
Lab Director PHILIP D. MAHAN

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