39D0184626 CLIA NUMBER - MAINLINE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 39D0184626
  • Facility Name: MAINLINE MEDICAL CENTER
  • Facility Address: 792 GALLITZIN ROAD
    CRESSON, PA
    ZIP 16630
  • Facility Phone: (814) 886-8161
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. PENNE H. EDGELL
  • NPI Number: 1205977642
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 39D0184626
LAB Type Physician Office
Facility Name MAINLINE MEDICAL CENTER
Street 792 GALLITZIN ROAD
City CRESSON
State PA
ZIP 16630
Phone 8148868161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2025
Certificate Expiration Date 7/31/2027
Facility Type Physician Office
Lab Director DR. PENNE H. EDGELL

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This page was last updated on: 5/15/2026