39D0187033 CLIA NUMBER - GREENCASTLE FAMILY PRACTICE PC

Laboratory Demographics

  • CLIA Code: 39D0187033
  • Facility Name: GREENCASTLE FAMILY PRACTICE PC
  • Facility Address: 50 EASTERN AVE SUITE 135
    GREENCASTLE, PA
    ZIP 17225
  • Facility Phone: 717 597-3151
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: NATHAN DERSTINE DO
  • NPI Number: 1629009295
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0187033
LAB Type Physician Office
Facility Name GREENCASTLE FAMILY PRACTICE PC
Street 50 EASTERN AVE SUITE 135
City GREENCASTLE
State PA
ZIP 17225
Phone 717 597-3151
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 6/20/2024
Certificate Expiration Date 6/19/2026
Facility Type Physician Office
Lab Director NATHAN DERSTINE DO

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