39D2328510 CLIA NUMBER - FREMONT FIRE DEPARTMENT

Laboratory Demographics

  • CLIA Code: 39D2328510
  • Facility Name: FREMONT FIRE DEPARTMENT
  • Facility Address: 8641 ROUTE 104
    MT PLEASANT MILLS, PA
    ZIP 17853
  • Facility Phone: 570 600-2786
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: JACOB A. WAGNER
  • NPI Number: 1699662114
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 39D2328510
LAB Type Ambulance
Facility Name FREMONT FIRE DEPARTMENT
Street 8641 ROUTE 104
City MT PLEASANT MILLS
State PA
ZIP 17853
Phone 570 600-2786
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2025
Certificate Expiration Date 8/11/2027
Facility Type Ambulance
Lab Director JACOB A. WAGNER

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