39D0186323 CLIA NUMBER - WELLSPAN FAMILY MEDICINE ELCO

Laboratory Demographics

  • CLIA Code: 39D0186323
  • Facility Name: WELLSPAN FAMILY MEDICINE ELCO
  • Facility Address: 6 PERRI AVENUE
    MYERSTOWN, PA
    ZIP 17067
  • Facility Phone: 717 949-6581
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. NICHOLAS A. BUCKWALTER
  • NPI Number: 1760510424
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0186323
LAB Type Physician Office
Facility Name WELLSPAN FAMILY MEDICINE ELCO
Street 6 PERRI AVENUE
City MYERSTOWN
State PA
ZIP 17067
Phone 717 949-6581
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/12/2024
Certificate Expiration Date 7/11/2026
Facility Type Physician Office
Lab Director DR. NICHOLAS A. BUCKWALTER

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