39D2138296 CLIA NUMBER - SHENANDOAH COMMUNITY AMBULANCE ASSOCIATION, INC

Laboratory Demographics

  • CLIA Code: 39D2138296
  • Facility Name: SHENANDOAH COMMUNITY AMBULANCE ASSOCIATION, INC
  • Facility Address: 220 N WHITE ST
    SHENANDOAH, PA
    ZIP 17976
  • Facility Phone: 570 426-0500
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MARK J. WIEKRYKAS
  • NPI Number: 1124010293
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 39D2138296
LAB Type Ambulance
Facility Name SHENANDOAH COMMUNITY AMBULANCE ASSOCIATION, INC
Street 220 N WHITE ST
City SHENANDOAH
State PA
ZIP 17976
Phone 570 426-0500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2025
Certificate Expiration Date 10/12/2027
Facility Type Ambulance
Lab Director MARK J. WIEKRYKAS

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