39D0190606 CLIA NUMBER - PENNSBURG FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 39D0190606
  • Facility Name: PENNSBURG FAMILY PRACTICE
  • Facility Address: 2793 GERYVILLE PIKE SUITE 200
    PENNSBURG, PA
    ZIP 18073
  • Facility Phone: 267 424-8200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. TINA M. MYERS
  • NPI Number: 1134164031
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D0190606
LAB Type Physician Office
Facility Name PENNSBURG FAMILY PRACTICE
Street 2793 GERYVILLE PIKE SUITE 200
City PENNSBURG
State PA
ZIP 18073
Phone 267 424-8200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2024
Certificate Expiration Date 2/2/2026
Facility Type Physician Office
Lab Director DR. TINA M. MYERS

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