39D2197635 CLIA NUMBER - THE GREEN HOME

Laboratory Demographics

  • CLIA Code: 39D2197635
  • Facility Name: THE GREEN HOME
  • Facility Address: 37 CENTRAL AVE
    WELLSBORO, PA
    ZIP 16901
  • Facility Phone: 570 724-3131
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. LARA JAUSSI
  • NPI Number: 1699772327
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D2197635
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name THE GREEN HOME
Street 37 CENTRAL AVE
City WELLSBORO
State PA
ZIP 16901
Phone 570 724-3131
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2024
Certificate Expiration Date 10/26/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. LARA JAUSSI

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