39D0181790 CLIA NUMBER - PENN HIGHLANDS BROKVLLE FMLY MED

Laboratory Demographics

CLIA Number: 39D0181790

Facility Name: PENN HIGHLANDS BROKVLLE FMLY MED

Facility Address:
88 HOSPITAL ROAD
BROOKVILLE, PA
ZIP 15825
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Facility Phone Number: 814 849-1874

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1760452924

Taxonomy: 282NC0060X - General Acute Care Hospital

CLIA Record

Field Name	Field Value
CLIA Number	39D0181790
LAB Type	Physician Office
Facility Name	PENN HIGHLANDS BROKVLLE FMLY MED
Street	88 HOSPITAL ROAD
City	BROOKVILLE
State	PA
ZIP	15825
Phone	814 849-1874
CertificateType	4
CertificateEffectiveDate	1/25/2023
CertificateExpirationDate	1/24/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024