39D2167167 CLIA NUMBER - NORTH CENTRAL PENNSYLVANIA DIALYSIS CLINICS LLC

Laboratory Demographics

CLIA Number: 39D2167167

Facility Name: NORTH CENTRAL PENNSYLVANIA DIALYSIS CLINICS LLC

Facility Address:
1660 SYCAMORE ROAD, SUITE B
MONTOURSVILLE, PA
ZIP 17754
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Facility Phone Number: 570 329-3300

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1114922416

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2167167
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	NORTH CENTRAL PENNSYLVANIA DIALYSIS CLINICS LLC
Street	1660 SYCAMORE ROAD, SUITE B
City	MONTOURSVILLE
State	PA
ZIP	17754
Phone	570 329-3300
CertificateType	4
CertificateEffectiveDate	6/4/2023
CertificateExpirationDate	6/3/2025
FacilityType	Waiver

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