39D2289398 CLIA NUMBER - JESSUP HOSE CO NO 2 AMBULANCE ASSOCIATION

Laboratory Demographics

CLIA Number: 39D2289398

Facility Name: JESSUP HOSE CO NO 2 AMBULANCE ASSOCIATION

Facility Address:
333 HILL STREET
JESSUP, PA
ZIP 18434
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Facility Phone Number: 570 489-1141

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1477612364

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	39D2289398
LAB Type	Ambulance
Facility Name	JESSUP HOSE CO NO 2 AMBULANCE ASSOCIATION
Street	333 HILL STREET
City	JESSUP
State	PA
ZIP	18434
Phone	570 489-1141
CertificateType	4
CertificateEffectiveDate	9/11/2023
CertificateExpirationDate	9/10/2025
FacilityType	Waiver

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