39D0177179 CLIA NUMBER - HAZELWOOD FAMILY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 39D0177179
  • Facility Name: HAZELWOOD FAMILY HEALTH CENTER
  • Facility Address: 4918 SECOND AVENUE
    PITTSBURGH, PA
    ZIP 15207
  • Facility Phone: 412 244-4728
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. MAMI GOTO
  • NPI Number: 1760552129
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D0177179
LAB Type Physician Office
Facility Name HAZELWOOD FAMILY HEALTH CENTER
Street 4918 SECOND AVENUE
City PITTSBURGH
State PA
ZIP 15207
Phone 412 244-4728
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 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Physician Office
Lab Director DR. MAMI GOTO

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