39D2204853 CLIA NUMBER - HAVEN PLACE

Laboratory Demographics

  • CLIA Code: 39D2204853
  • Facility Name: HAVEN PLACE
  • Facility Address: 24 CREE DRIVE
    LOCK HAVEN, PA
    ZIP 17745
  • Facility Phone: 570 893-5132
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. BORIS GORALNIK
  • NPI Number: 1487175816
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D2204853
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HAVEN PLACE
Street 24 CREE DRIVE
City LOCK HAVEN
State PA
ZIP 17745
Phone 570 893-5132
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2024
Certificate Expiration Date 12/9/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. BORIS GORALNIK

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