39D2139369 CLIA NUMBER - EAST WHITELAND TWP VOL FIRE ASSN

Laboratory Demographics

CLIA Number: 39D2139369

Facility Name: EAST WHITELAND TWP VOL FIRE ASSN

Facility Address:
205 CONESTOGA ROAD
MALVERN, PA
ZIP 19355
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Facility Phone Number: 610 644-0855

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1043331895

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	39D2139369
LAB Type	Ambulance
Facility Name	EAST WHITELAND TWP VOL FIRE ASSN
Street	205 CONESTOGA ROAD
City	MALVERN
State	PA
ZIP	19355
Phone	610 644-0855
CertificateType	4
CertificateEffectiveDate	11/2/2023
CertificateExpirationDate	11/1/2025
FacilityType	Waiver

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