39D0188834 CLIA NUMBER - LEE M CICCARELLI MD

Laboratory Demographics

  • CLIA Code: 39D0188834
  • Facility Name: LEE M CICCARELLI MD
  • Facility Address: 429 WASHINGTON BLVD
    WILLIAMSPORT, PA
    ZIP 17701
  • Facility Phone: 717 327-9480
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LEE M. CICCARELLI
  • NPI Number: 1417909029
  • Taxonomy: 174400000X - Specialist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 39D0188834
LAB Type Physician Office
Facility Name LEE M CICCARELLI MD
Street 429 WASHINGTON BLVD
City WILLIAMSPORT
State PA
ZIP 17701
Phone 717 327-9480
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director LEE M. CICCARELLI

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