39D0175601 CLIA NUMBER - HENRY E HOLETS JR MD LLC

Laboratory Demographics

  • CLIA Code: 39D0175601
  • Facility Name: HENRY E HOLETS JR MD LLC
  • Facility Address: 1290 CHESS STREET SECOND FLOOR
    MONONGAHELA, PA
    ZIP 15063
  • Facility Phone: 724 258-7500
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: HENRY E. HOLETS JR MD
  • NPI Number: 1083638043
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0175601
LAB Type Physician Office
Facility Name HENRY E HOLETS JR MD LLC
Street 1290 CHESS STREET SECOND FLOOR
City MONONGAHELA
State PA
ZIP 15063
Phone 724 258-7500
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/18/2024
Certificate Expiration Date 3/17/2026
Facility Type Physician Office
Lab Director HENRY E. HOLETS JR MD

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