39D2139109 CLIA NUMBER - CLARKS SUMMIT FIRE CO NO 1 INC

Laboratory Demographics

CLIA Number: 39D2139109

Facility Name: CLARKS SUMMIT FIRE CO NO 1 INC

Facility Address:
321 BEDFORD ST
CLARKS SUMMIT, PA
ZIP 18411
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Facility Phone Number: 570 586-9656

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1720124795

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	39D2139109
LAB Type	Ambulance
Facility Name	CLARKS SUMMIT FIRE CO NO 1 INC
Street	321 BEDFORD ST
City	CLARKS SUMMIT
State	PA
ZIP	18411
Phone	570 586-9656
CertificateType	4
CertificateEffectiveDate	10/31/2023
CertificateExpirationDate	10/30/2025
FacilityType	Waiver

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