39D0187469 CLIA NUMBER - MEMORIAL FAMILY MEDICINE AT STEWARTSTOWN

Laboratory Demographics

  • CLIA Code: 39D0187469
  • Facility Name: MEMORIAL FAMILY MEDICINE AT STEWARTSTOWN
  • Facility Address: 200 BAILEY DRIVE SUITE 101
    STEWARTSTOWN, PA
    ZIP 17363
  • Facility Phone: (717) 993-2543
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. NILOOFAR V. ROODSARI
  • NPI Number: 1982133369
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0187469
LAB Type Physician Office
Facility Name MEMORIAL FAMILY MEDICINE AT STEWARTSTOWN
Street 200 BAILEY DRIVE SUITE 101
City STEWARTSTOWN
State PA
ZIP 17363
Phone 7179932543
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type Physician Office
Lab Director DR. NILOOFAR V. ROODSARI

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This page was last updated on: 5/18/2026