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39D0187469 CLIA NUMBER - MEMORIAL FAMILY MEDICINE AT STEWARTSTOWN

Laboratory Demographics

CLIA Number: 39D0187469

Facility Name: MEMORIAL FAMILY MEDICINE AT STEWARTSTOWN

Facility Address:
200 BAILEY DRIVE, SUITE 101
STEWARTSTOWN, PA
ZIP 17363
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Facility Phone Number: 717 993-2543

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1982133369

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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 717 993-2543
CertificateType 4
CertificateEffectiveDate 9/12/2023
CertificateExpirationDate 9/11/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024