39D0184761 CLIA NUMBER - HEATON FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 39D0184761
  • Facility Name: HEATON FAMILY PRACTICE LLC
  • Facility Address: 111 NSON DRIVE SUITE 103
    ROARING SPRING, PA
    ZIP 16673
  • Facility Phone: 814 224-2213
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FRED HEATON DO
  • NPI Number: 1154588499
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0184761
LAB Type Physician Office
Facility Name HEATON FAMILY PRACTICE LLC
Street 111 NSON DRIVE SUITE 103
City ROARING SPRING
State PA
ZIP 16673
Phone 814 224-2213
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 Physician Office
Lab Director FRED HEATON DO

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