39D2243421 CLIA NUMBER - PYRAMID HEALTHCARE PINE RIDGE MANOR HWH

Laboratory Demographics

CLIA Number: 39D2243421

Facility Name: PYRAMID HEALTHCARE PINE RIDGE MANOR HWH

Facility Address:
13505 SOUTH EAGLE VALLEY ROAD
TYRONE, PA
ZIP 16686
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Facility Phone Number: 814 940-0407

Facility Type: Other - DRUG&ALCOHOLHALFWAY HOUSE

Certificate Type: Waiver

NPI Number: 1033230461

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2243421
LAB Type	Other - DRUG&ALCOHOLHALFWAY HOUSE
Facility Name	PYRAMID HEALTHCARE PINE RIDGE MANOR HWH
Street	13505 SOUTH EAGLE VALLEY ROAD
City	TYRONE
State	PA
ZIP	16686
Phone	814 940-0407
CertificateType	4
CertificateEffectiveDate	11/18/2023
CertificateExpirationDate	11/17/2025
FacilityType	Waiver

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