39D0188275 CLIA NUMBER - WELLSPAN FAMILY MEDICINE-TERRE HILL

Laboratory Demographics

  • CLIA Code: 39D0188275
  • Facility Name: WELLSPAN FAMILY MEDICINE-TERRE HILL
  • Facility Address: 770 BROAD STREET
    EAST EARL, PA
    ZIP 17519
  • Facility Phone: 717 445-4576
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: DR. BRUCE C. WASKOWICZ
  • NPI Number: 1265983613
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 39D0188275
LAB Type Practitioner Other
Facility Name WELLSPAN FAMILY MEDICINE-TERRE HILL
Street 770 BROAD STREET
City EAST EARL
State PA
ZIP 17519
Phone 717 445-4576
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 9/16/2024
Certificate Expiration Date 9/15/2026
Facility Type Practitioner Other
Lab Director DR. BRUCE C. WASKOWICZ

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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