39D2150789 CLIA NUMBER - PROMISED LAND VOL AMBULANCE

Laboratory Demographics

CLIA Number: 39D2150789

Facility Name: PROMISED LAND VOL AMBULANCE

Facility Address:
1054 RT 390
GREENTOWN, PA
ZIP 18426
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Facility Phone Number: 570 676-3818

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1619036548

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	39D2150789
LAB Type	Ambulance
Facility Name	PROMISED LAND VOL AMBULANCE
Street	1054 RT 390
City	GREENTOWN
State	PA
ZIP	18426
Phone	570 676-3818
CertificateType	4
CertificateEffectiveDate	7/3/2022
CertificateExpirationDate	7/2/2024
FacilityType	Waiver

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