39D2254600 CLIA NUMBER - LOG SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 39D2254600
  • Facility Name: LOG SURGERY CENTER, LLC
  • Facility Address: 413 GRANITE RUN DRIVE
    LANCASTER, PA
    ZIP 17601
  • Facility Phone: 717 205-8964
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL J. BERCIK
  • NPI Number: 1326632936
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2254600
LAB Type Ambulatory Surgery Center
Facility Name LOG SURGERY CENTER, LLC
Street 413 GRANITE RUN DRIVE
City LANCASTER
State PA
ZIP 17601
Phone 717 205-8964
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/7/2024
Certificate Expiration Date 3/6/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. MICHAEL J. BERCIK

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