39D0189866 CLIA NUMBER - SOUTH MOUNTAIN FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 39D0189866
  • Facility Name: SOUTH MOUNTAIN FAMILY PRACTICE
  • Facility Address: 1545 BROADWAY
    BETHLEHEM, PA
    ZIP 18015
  • Facility Phone: 610 865-6112
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MICHAEL ABGOTT MD
  • NPI Number: 1700984622
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0189866
LAB Type Physician Office
Facility Name SOUTH MOUNTAIN FAMILY PRACTICE
Street 1545 BROADWAY
City BETHLEHEM
State PA
ZIP 18015
Phone 610 865-6112
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 7/17/2024
Certificate Expiration Date 7/16/2026
Facility Type Physician Office
Lab Director MICHAEL ABGOTT MD

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