39D2136713 CLIA NUMBER - CHESTNUT RIDGE AMBULANCE

Laboratory Demographics

CLIA Number: 39D2136713

Facility Name: CHESTNUT RIDGE AMBULANCE

Facility Address:
4037 QUAKER VALLEY RD
ALUM BANK, PA
ZIP 15521
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Facility Phone Number: 814 839-2774

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1952331076

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	39D2136713
LAB Type	Ambulance
Facility Name	CHESTNUT RIDGE AMBULANCE
Street	4037 QUAKER VALLEY RD
City	ALUM BANK
State	PA
ZIP	15521
Phone	814 839-2774
CertificateType	4
CertificateEffectiveDate	9/14/2023
CertificateExpirationDate	9/13/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024