39D0188312 CLIA NUMBER - WILLOW VALLEY LAKES MANOR

Laboratory Demographics

  • CLIA Code: 39D0188312
  • Facility Name: WILLOW VALLEY LAKES MANOR
  • Facility Address: 300 WILLOW VALLEY LAKES DR ATTN LAKESIDE DIRECTOR OF NURSING
    WILLOW STREET, PA
    ZIP 17584
  • Facility Phone: 717 464-0286
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: THOMAS D. BRAIDE
  • NPI Number: 1740351584
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D0188312
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WILLOW VALLEY LAKES MANOR
Street 300 WILLOW VALLEY LAKES DR ATTN LAKESIDE DIRECTOR OF NURSING
City WILLOW STREET
State PA
ZIP 17584
Phone 717 464-0286
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director THOMAS D. BRAIDE

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