39D2136714 CLIA NUMBER - EAST PENNSBORO AMBULANCE SERVICE, INC

Laboratory Demographics

CLIA Number: 39D2136714

Facility Name: EAST PENNSBORO AMBULANCE SERVICE, INC

Facility Address:
750 S HUMER ST
ENOLA, PA
ZIP 17025
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Facility Phone Number: 717 732-5552

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1073519567

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	39D2136714
LAB Type	Ambulance
Facility Name	EAST PENNSBORO AMBULANCE SERVICE, INC
Street	750 S HUMER ST
City	ENOLA
State	PA
ZIP	17025
Phone	717 732-5552
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