39D2141482 CLIA NUMBER - PAUL M RUTKOWSKI DO PC

Laboratory Demographics

  • CLIA Code: 39D2141482
  • Facility Name: PAUL M RUTKOWSKI DO PC
  • Facility Address: 540 PIERCE ST
    KINGSTON, PA
    ZIP 18704
  • Facility Phone: 570 285-3520
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. PAUL M. RUTKOWSKI
  • NPI Number: 1164875464
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D2141482
LAB Type Physician Office
Facility Name PAUL M RUTKOWSKI DO PC
Street 540 PIERCE ST
City KINGSTON
State PA
ZIP 18704
Phone 570 285-3520
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2023
Certificate Expiration Date 12/13/2025
Facility Type Physician Office
Lab Director DR. PAUL M. RUTKOWSKI

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