08D2058212 CLIA NUMBER - DOUGLAS J LAVENBURG, MD, PA

Laboratory Demographics

  • CLIA Code: 08D2058212
  • Facility Name: DOUGLAS J LAVENBURG, MD, PA
  • Facility Address: 1 CENTURIAN DRIVE
    NEWARK, DE
    ZIP 19713
  • Facility Phone: 302 993-0722
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. KIMBERLY BRISTOW
  • NPI Number: 1124129747
  • Taxonomy: 207RR0500X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 08D2058212
LAB Type Physician Office
Facility Name DOUGLAS J LAVENBURG, MD, PA
Street 1 CENTURIAN DRIVE
City NEWARK
State DE
ZIP 19713
Phone 302 993-0722
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/2/2025
Certificate Expiration Date 5/1/2027
Facility Type Physician Office
Lab Director DR. KIMBERLY BRISTOW

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