39D0185984 CLIA NUMBER - WELLSPAN DIXON FNDN HEALTH CENTR

Laboratory Demographics

  • CLIA Code: 39D0185984
  • Facility Name: WELLSPAN DIXON FNDN HEALTH CENTR
  • Facility Address: 30 NORTH 4TH ST
    LEBANON, PA
    ZIP 17046
  • Facility Phone: 717 270-7799
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: DR. JACKIE N. SEES
  • NPI Number: 1578014007
  • Taxonomy: 207RG0100X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 39D0185984
LAB Type Ancillary Testing Site in Health Care Center
Facility Name WELLSPAN DIXON FNDN HEALTH CENTR
Street 30 NORTH 4TH ST
City LEBANON
State PA
ZIP 17046
Phone 717 270-7799
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 Ancillary Testing Site in Health Care Center
Lab Director DR. JACKIE N. SEES

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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