39D0183967 CLIA NUMBER - LECOM AT VILLAGE SQUARE

Laboratory Demographics

  • CLIA Code: 39D0183967
  • Facility Name: LECOM AT VILLAGE SQUARE
  • Facility Address: 149 W 22ND ST
    ERIE, PA
    ZIP 16502
  • Facility Phone: 814 452-3271
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. DANIELLE M. HANSEN
  • NPI Number: 1689231029
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D0183967
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LECOM AT VILLAGE SQUARE
Street 149 W 22ND ST
City ERIE
State PA
ZIP 16502
Phone 814 452-3271
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. DANIELLE M. HANSEN

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