39D2327530 CLIA NUMBER - PENNSYLVANIA AMBULANCE LLC

Laboratory Demographics

  • CLIA Code: 39D2327530
  • Facility Name: PENNSYLVANIA AMBULANCE LLC
  • Facility Address: 717 CAPOUSE AVE
    SCRANTON, PA
    ZIP 18509
  • Facility Phone: 570 558-1212
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: BRUCE BEAUVAIS
  • NPI Number: 1124454566
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 39D2327530
LAB Type Ambulance
Facility Name PENNSYLVANIA AMBULANCE LLC
Street 717 CAPOUSE AVE
City SCRANTON
State PA
ZIP 18509
Phone 570 558-1212
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/24/2025
Certificate Expiration Date 7/23/2027
Facility Type Ambulance
Lab Director BRUCE BEAUVAIS

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