39D0187221 CLIA NUMBER - WELLSPAN FAMILY MED FAIRFIELD

Laboratory Demographics

  • CLIA Code: 39D0187221
  • Facility Name: WELLSPAN FAMILY MED FAIRFIELD
  • Facility Address: 4910-A FAIRFIELD ROAD
    FAIRFIELD, PA
    ZIP 17320
  • Facility Phone: 717 851-7481
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. NANCY D. NAGIB
  • NPI Number: 1689754079
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D0187221
LAB Type Physician Office
Facility Name WELLSPAN FAMILY MED FAIRFIELD
Street 4910-A FAIRFIELD ROAD
City FAIRFIELD
State PA
ZIP 17320
Phone 717 851-7481
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 8/1/2024
Certificate Expiration Date 7/31/2026
Facility Type Physician Office
Lab Director DR. NANCY D. NAGIB

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