39D0183510 CLIA NUMBER - RONALD M UNICE DO LABORATORY

Laboratory Demographics

CLIA Number: 39D0183510

Facility Name: RONALD M UNICE DO LABORATORY

Facility Address:
765 LIBERTY STREET STE 109
MEADVILLE, PA
ZIP 16335
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Facility Phone Number: 814 337-5373

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1578532727

Taxonomy: 363AM0700X - Physician Assistant

CLIA Record

Field Name	Field Value
CLIA Number	39D0183510
LAB Type	Physician Office
Facility Name	RONALD M UNICE DO LABORATORY
Street	765 LIBERTY STREET STE 109
City	MEADVILLE
State	PA
ZIP	16335
Phone	814 337-5373
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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